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(영문) 전주지방법원 2017.11.29 2017가단3071
부당이득금
Text

1. The instant lawsuit shall be dismissed.

2. The costs of lawsuit shall be borne by the Plaintiff.

Reasons

1. Facts of recognition;

A. 1) The Plaintiff is the Plaintiff’s status as the party. The Plaintiff is the Plaintiff’s Institute of Foreign Affairs (hereinafter “Plaintiff Hospital”).

(2) The Defendants are insurers selling indemnity medical insurance products.

B. The Plaintiff hospital, which paid the insurance money of the Defendant Company, is specialized in the Jindom Satom surgery (hereinafter “matom surgery”) for patients who have been cultivated in the room. The Plaintiff issued a certificate of entrance discharge to patients who entered into an injury insurance contract with the Defendants, and the said patients were issued insurance money by submitting the certificate of entrance discharge, etc. to the Defendants.

C. On December 26, 2012, the Plaintiff was issued a summary order of KRW 7 million due to the following facts constituting a crime of fraud by the Jeonju District Court 2012 high-level8175, but filed a request for formal trial.

The defendant is the director of the foreign medical department in the Jeonju-si B, who directly takes charge of the overall operation of the hospital, such as operating expenses for patients, consultation on insurance relations, medical treatment, surgery, confirmation of entrance and discharge, and issuance of medical certificates, or supervises the employees of the hospital.

The hospital operated by the defendant is a hospital specializing in the training type of relics and textile type treatment and removal surgery, and the method of the procedure is using Mamomoom surgery.

The operation through the above method is a non-benefit item that is not included in the insurance benefits of the National Health Insurance Corporation, and it is individually covered by the accident insurance of the private insurance company and must be hospitalized after the operation, but 30% or 100% of the medical expenses to be borne by the patient himself/herself according to the terms and conditions of the medical expenses for loss of the private insurance company can be paid.

However, it is not necessary to continuously observe and treat doctors such as medication and treatment after the operation, and it is also necessary to discharge them immediately after stabilizing at the recovery room.

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