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1. The Defendant’s KRW 3,768,720 as well as 5% per annum from August 25, 2012 to January 23, 2015 to the Plaintiff.
Reasons
1. Basic facts
A. On July 24, 2012, Nonparty A was treated as a traffic accident patient at the Gelim University Sexual Hospital (hereinafter “Plaintiff Hospital”), which was operated by the Plaintiff, after an incomplete aggregate diagnosis accompanied by an in-depth tension due to the 6-7 maleculical damage and new damage.
B. On August 24, 2012, the Plaintiff filed a claim for KRW 21,391,940, including the ancillary Nos. 1 through 3 treatment expenses (hereinafter “instant medical expenses”) with the Defendant, the insurer of the vehicle involved in the instant traffic accident. On October 24, 2012, the Defendant paid KRW 17,328,000, excluding the instant medical treatment expenses, etc. on October 24, 2012.
C. The Defendant filed a petition for review of medical expenses with the Medical Fee Insurance Dispute Resolution Council (hereinafter “Dispute Resolution Council”) on the ground that some of the medical expenses in the first to third cases constitute excessive treatment. The Dispute Resolution Council reduced 2,839,40 won by the sum of the medical expenses in the first to 3 medical expenses in the instant case, and decided to the effect that the Plaintiff should bear 33,940 won with the examination fees in the instant medical expenses in the instant case from 1,066,231 won [4,06,940 won (21,391,940 won - 17,328,000 won - 17,339,400 won with the Plaintiff’s consent] - The Defendant shall pay the Plaintiff for the medical expenses in the instant case from 1 to 309 won (hereinafter “instant decision”).
The definitions of terms used in this Act shall be as follows [Guarantee of Automobile Accident Compensation] Article 2 (Definitions]
7. The term "medical fee covered by automobile accident insurance" means the amount of expenses incurred in receiving medical treatment from a medical institution under the Medical Service Act by a person who has suffered an accident caused by the operation of a motor vehicle, which falls under any of the following items:
The relevant expenses shall be the insurance money (including mutual aid money; hereinafter referred to as "insurance money, etc.") of an insurance company (including a mutual aid business operator; hereinafter referred to as "insurance company, etc.").