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(영문) 서울중앙지방법원 2020.01.10 2019나39385
구상금
Text

1. Revocation of the first instance judgment.

2. The plaintiff's claim is dismissed.

3. All costs of the lawsuit shall be borne by the Plaintiff.

Reasons

1. Facts of recognition;

A. C and D, on October 16, 2013, caused a traffic accident, and received treatment, such as pharmacological therapy, from the Defendant’s “E” as a result of the Defendant’s operation.

The plaintiff is an insurer who has concluded a comprehensive motor vehicle insurance contract with the above traffic accident victim vehicles, and has guaranteed the payment of the medical expenses.

B. On January 7, 2014, the Defendant filed a claim with the Health Insurance Review and Assessment Service (hereinafter “Review and Assessment Service”) for review of motor vehicle insurance medical fees for C and D, and the Review and Assessment Service recognized the full amount of the medical fees claimed by the Defendant as motor vehicle insurance medical fees (hereinafter “instant review and Decision”), and the Plaintiff did not raise any objection to the said review and Decision, and paid the full amount of the medical fees to the Defendant from January 22, 2014 to February 19, 2014.

C. On July 8, 2014, the Review and Assessment Service notified the Defendant of the result of the review that “the sum of KRW 280,370 (i.e., 243,800 and the amount calculated by applying a premium rate of 15% to the amount of review and decision and the additional dues applied thereto) paid for the period during which the claim was filed (hereinafter “instant recovery notification”)” (hereinafter “instant recovery notification”). On July 9, 2014, the Review and Assessment Service sent the Plaintiff a written notification of the same content.

Accordingly, on July 16, 2014, the Defendant raised an objection against the instant restitution notice to the Review and Assessment Service, and the Review and Assessment Service rendered a decision to dismiss the Defendant’s objection, and sent it via information and communications networks.

E. On September 25, 2014, the Defendant filed an administrative suit against the Review and Assessment Service seeking revocation of the instant restitution notice under the Seoul Administrative Court 2014Guhap17104, but was sentenced on April 9, 2015 on the ground that the instant restitution notice cannot be a disposition subject to an appeal litigation.

The defendant is dissatisfied with this and filed an appeal with Seoul High Court No. 2015Nu42581, but the dismissal of the appeal has been ruled.

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