Cases
2013 Doz. 43188 Unjust Enrichment
Plaintiff
National Health Insurance Corporation
Defendant
A
Conclusion of Pleadings
April 16, 2014
Imposition of Judgment
April 23, 2014
Text
1. The defendant shall pay to the plaintiff 126,273,880 won with 5% interest per annum from May 3, 2013 to April 23, 2014, and 20% interest per annum from the next day to the day of complete payment.
2. The plaintiff's remaining claims are dismissed.
3. The costs of lawsuit shall be borne by the defendant.
4. Paragraph 1 can be provisionally executed.
Purport of claim
The defendant shall pay to the plaintiff 126,273,80 won and the amount indicated in the medical expenses column for the plaintiff's medical expenses on the calculation sheet of attached damages, 5% per annum from the day following the day on which each date on which the medical expenses are indicated in the medical expenses payment notice to the day of delivery of the copy of the complaint of this case, and 20% per annum from the next day to the day of complete payment
Reasons
1. Facts of recognition;
A. B, who was employed by the Defendant, suffered injury, such as an injury on the b.5m below the ground from among the works of removal works conducted in D located in Jin-gu Busan, Jin-gu, Busan (hereinafter “instant accident”), due to an accident falling below 2.5m below the surface (hereinafter “instant accident”).
B. From September 26, 2009 to October 22, 2012, the Plaintiff’s insured Party B received medical treatment from each medical care institution listed in the column for the calculation sheet of damages in attached Form No. 126,273,80 won as stated in the attached Form No. 209 to each medical care institution. The Plaintiff paid 126,273,880 won of the Corporation’s charges to each medical care institution as stated in the attached Form No. 209 to each of the instant accidents (based on recognition).
2. Occurrence of liability for return of unjust gains;
Article 78(1) of the Labor Standards Act provides that an employer shall provide necessary medical care at his/her expense or bear necessary medical care expenses when an employee suffers from an occupational injury or disease. Article 87 of the same Act provides that an employer shall be exempted from liability for compensation to the extent of the value that the employee receives money and other valuables equivalent to accident compensation under this Act for the same reason, in accordance with the Civil Act and other Acts and subordinate statutes. If an employee receives benefits equivalent to the medical care compensation under Article 78(1) of the Labor Standards Act from a third party other than the employee who suffers from an occupational accident, he/she may not exercise the employer’s right to claim medical care due to an occupational accident. Therefore, the employer is obligated to return the benefits that the employee would have discharged the third party who provided the benefits equivalent to the medical care compensation (see, e.g., Supreme Court Decision 2004Da12660, Apr. 28, 2005).
In this case, according to the above facts, the defendant, as the employer of B, was obligated to compensate for medical care due to the accident of this case pursuant to Article 78 (1) of the Labor Standards Act, and was exempted from the obligation to compensate for medical care due to the plaintiff's loss, thereby gaining profits equivalent to the amount of the Corporation's charges without any legal ground and causing damage to the plaintiff. Thus, the defendant is obligated to return it to the plaintiff.
Therefore, the Defendant is obligated to pay to the Plaintiff damages for delay calculated by the ratio of 5% per annum under the Civil Act from May 3, 2013, which is the date following the delivery date of a copy of the complaint in this case, to April 23, 2014, and 20% per annum under the Act on Special Cases Concerning the Promotion, etc. of Legal Proceedings from the next day to the date of complete payment.
Furthermore, with respect to each of the charges borne by the Plaintiff, the Plaintiff also claimed damages for delay from the day following each of the respective payment dates until the delivery date of the duplicate of the instant complaint. However, the obligation to return unjust enrichment is a debt for which the due date is not specified and thus, is liable for delay only when the obligor receives a claim for performance (see Supreme Court Decision 2009Da24718, 24194, Jan. 28, 2010). Since there is no steam to acknowledge that the Plaintiff sought payment of the charges to the Defendant prior to the filing of the instant suit, this part
3. Defendant’s assertion and judgment
In a lawsuit where B and their families claim damages against the Defendant amounting to KRW 99,454,050, the Defendant paid KRW 40,000 to B wife E as consolation money, which was established on November 7, 2013, and the conciliation was established on November 7, 2013, which took into account that B’s negligence was 50%, and thus, the Defendant’s unjust enrichment that the Plaintiff should return to the Plaintiff should also be considered.
The employer is obligated to pay the full amount of compensation for medical care under the Labor Standards Act, barring special circumstances, and even if there is any negligence on the part of the employee, it cannot avoid paying an amount equivalent to the ratio (see, e.g., Supreme Court en banc Decision 81Meu351, Oct. 13, 1981; Supreme Court Decision 2009Da97314, Feb. 25, 2010; Supreme Court Decision 2009Da97314, Feb. 25, 2010); and the Defendant’s above assertion that the Defendant’
4. Conclusion
Therefore, the plaintiff's claim is justified within the above scope of recognition, and the remaining claims are dismissed as it is without merit. It is so decided as per Disposition.
Judges
The presiding judge, the senior judge;
Judges Kim Tae-jin
Judges Lee Jae-in