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(영문) 대전지방법원 2015.07.17 2014구단736
요양급여불승인처분취소
Text

1. The plaintiff's claim is dismissed.

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

Reasons

1. Details of the disposition;

A. On April 17, 2013, the Plaintiff filed a claim against the Defendant for medical care benefits for “Acheon 4th CY” (hereinafter “CY”) and the Defendant rendered a disposition not to grant medical care approval (hereinafter “instant disposition”) against the Plaintiff on the ground that “The causal relationship between an occupational accident and an applicant’s disease is not confirmed” (hereinafter “instant disposition”).

B. The Plaintiff filed a petition for review with the Defendant on October 4, 2013, and the Defendant dismissed the petition for review against the Plaintiff on the ground that “CT inspection results show no verified disease or injury.”

(A) A. (A. (A.) No. 1 and No. 2, and the purport of the entire pleadings, together with a claim for medical care benefits, a disposition not to grant medical care, a request for review, and a review of the case against an injury or disease other than an injury or disease on the ground of recognition).

2. Whether the instant disposition is lawful

A. The instant disposition is unlawful since the Plaintiff’s occupational accident caused the injury or disease to the Plaintiff.

B. According to the result of the court’s commission of physical examination of the B-university hospital, the applicant’s disease cannot be confirmed to the Plaintiff.

With respect to the occurrence of an injury or disease to the Plaintiff, it is not sufficient to recognize the Plaintiff solely with the statement of Gap evidence No. 4, and there is no other evidence to acknowledge it.

Therefore, the plaintiff's assertion is without merit, and the disposition of this case is legitimate.

3. The plaintiff's claim is dismissed as it is without merit. It is so decided as per Disposition.

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