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(영문) 대법원 2015.02.10 2014다225212
부당이득금
Text

The judgment below

Among them, the part of the claim against A is reversed, and this part of the case is to the Suwon District Court Panel Division.

Reasons

The grounds of appeal are examined.

1. Supreme Court Decision 2014Da44376 Decided November 27, 2014 rendered the following judgments.

Article 42(1) of the Industrial Accident Compensation Insurance Act (hereinafter “Industrial Accident Insurance Act”) provides that “A person who has filed an application for medical care benefits under the Industrial Accident Compensation Insurance Act (hereinafter “Industrial Accident Insurance Act”) may receive medical care benefits under the National Health Insurance Act (hereinafter “Health Insurance”) before the Korea Workers’ Compensation and Welfare Service makes a decision on the medical care benefits for industrial accident insurance (hereinafter “decision on approval for additional medical care”).” Article 90(1) of the Industrial Accident Insurance Act provides that “The Korea Workers’ Compensation and Welfare Service shall first pay health care benefits to the beneficiaries of industrial accident insurance benefits pursuant to Article 42(1) of the Industrial Accident Insurance Act and claims the expenses thereof, the Korea Workers’ Compensation and Welfare Service may pay the amount equivalent to the medical care benefits if the health insurance benefits are deemed equivalent to the medical care benefits that can be paid under the Industrial Accident Insurance Act.” Article 112(1)5 of the Industrial Accident Insurance Act provides that “If the rights of the National Health Insurance Corporation under Article 90(1) of the Industrial Accident Insurance Act for three years are not exercised.

Article 53(1)4 of the National Health Insurance Act provides that no health insurance benefit shall be provided to a person eligible for industrial accident insurance benefits, and even if an employee who was injured or affected by a disease (hereinafter referred to as "victim") files an application for medical care benefits for industrial accident insurance due to occupational reasons, health insurance benefits may also arise due to absence of medical care benefits for industrial accident insurance until approval for additional medical care is rendered by a decision to grant additional medical care.

Articles 42(1) and 90(1) of the Industrial Accident Insurance Act are occupational injury or injury to the affected workers by the National Health Insurance Corporation in order to eliminate such blank state of social insurance.

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