National Health Insurance Corporation

Defendant (Attorney Full Il-il, Counsel for defendant-appellant)

June 19, 2013

Daegu District Court Decision 2012Gadan205198 Decided January 29, 2013

1. The plaintiff's appeal is dismissed.

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

The judgment of the first instance shall be revoked. The defendant shall pay to the plaintiff 90,887,180 won with 5% interest per annum from February 2, 2012 to the service date of a copy of the complaint of this case, and 20% interest per annum from the next day to the day of full payment.

1. Quotation of judgment of the first instance;

The reasoning for this Court’s explanation concerning this case is as stated in the reasoning of the judgment of the court of first instance, except for adding the following judgments to the pertinent part. Thus, this Court’s reasoning is cited by Article 420 of the Civil Procedure Act.

2. Additional matters to be determined;

A. Summary of the plaintiff's assertion

The scope of medical care compensation under the Industrial Accident Compensation Insurance Act and the scope of employer's liability for medical care compensation under the Labor Standards Act are not identical, and the scope of employer's liability for medical care compensation under the Industrial Accident Compensation Insurance Act is larger than that of the Industrial Accident Compensation Insurance Act, and in cases where hospital treatment for the non-party after December 20, 2007 is not subject to additional medical care (or cases where the non-party becomes unable to receive medical care benefits from the Korea Workers' Compensation and Welfare Service after receiving medical treatment closure disposition from the Korea Workers' Compensation and Welfare Service), the defendant is still liable for medical care compensation under the Labor Standards Act. Accordingly, the plaintiff paid the non-party's medical care charge out of the occupational after the occupational accident to the hospital without any legal ground, and the defendant obtains the benefit that the non-party is exempted from the liability for medical care compensation under the Labor Standards Act, and the defendant is obligated to return

B. Determination

Article 78(1) of the Labor Standards Act provides, “If an employee suffers from an occupational accident or disease, the employer shall provide necessary medical care at his/her expense or bear necessary medical care expenses.” Article 78(2) of the same Act provides, “The scope of occupational disease and medical care and the timing of medical care compensation under paragraph (1) shall be prescribed by Presidential Decree.” Article 44(1) and attached Table 5 of the Enforcement Decree of the same Act provides, “The scope of medical care shall be prescribed by Presidential Decree.”

In addition, Article 40(1) of the Industrial Accident Compensation Insurance Act provides that "medical care benefits shall be paid to a worker who suffers from an injury or disease due to an occupational reason," and Article 40(4) of the same Act provides that "the scope of medical care benefits shall be provided to a medical examination, examination, medicine or treatment materials, and artificial limbs or other auxiliary devices, treatment, surgery, other medical treatment, rehabilitation treatment, hospitalization, nursing, nursing, and transfer." In relation to "additional medical care benefits", Article 49 of the same Act provides that "if a worker under medical care due to an occupational accident is additionally discovered an injury or disease which has already occurred due to an occupational accident and needs medical care due to a new disease due to the occupational accident, it may apply for medical care benefits for the injury or disease (hereinafter referred to as "additional injury or disease")." In relation to "additional medical care", Article 51(1) of the same Act provides that "if a person who suffers from an injury or disease after receiving medical care pursuant to Article 40 (1) of the same Act needs to be recovered or aggravated, it can be recovered."

In addition, the purport of Article 80(1) of the Industrial Accident Compensation Insurance Act provides that the State shall directly compensate an employee for any loss caused by an occupational accident of an employee who is liable to compensate under the Labor Standards Act from the standpoint of the insurer (see Supreme Court Decision 93Da38826, May 24, 1994). Article 80(1) of the Industrial Accident Compensation Insurance Act provides that “If a beneficiary has received or is entitled to receive insurance benefits under this Act, the insured shall be exempted from the liability for accident compensation under the Labor Standards Act for the same reason” is that the employer shall be exempted from the liability for accident compensation under the Labor Standards Act in cases where the beneficiary has already taken out the industrial accident compensation insurance and has to pay the insurance benefits in relation to the relevant accident (see Supreme Court Decision 2001Da7834, Sept.

In full view of the contents and purport of the above-mentioned laws, the scope of the Industrial Accident Compensation Insurance Act and the scope of the employer's liability for medical care under the Labor Standards Act are deemed to be identical. In case the Korea Workers' Compensation & Welfare Service added an injury or disease to an employee after the payment of medical care benefits to the employee due to an existing occupational injury or disease, or re-influence or re-influence of an additional injury or disease, it is judged that the Industrial Accident Compensation Insurance Act does not reduce it compared to the scope of the existing medical care compensation. Therefore, it is difficult to determine that the scope of the medical care compensation under the Industrial Accident Compensation Insurance Act and the scope of the employer's liability for medical care under the Labor Standards Act even

Therefore, the plaintiff's above assertion on the premise that the scope of medical care compensation under the Industrial Accident Compensation Insurance Act and the scope of employer's liability for medical care compensation is different is without merit.

3. Conclusion

Therefore, the judgment of the court of first instance is legitimate, and the plaintiff's appeal is dismissed. It is so decided as per Disposition.

Judges Kim Jong-sung (Presiding Judge)

1) In relation to the requirements for such additional medical care, active treatment, such as surgery (including surgery to remove a fixed object inside the body or re-operation on the part of the body) is deemed necessary for the improvement of the state of injury or disease subject to the additional medical care, and the state of injury or disease subject to the additional medical care is deemed to have proximate causal link between the affected occupational injury or disease and the injury or disease subject to the additional medical care. The state of the injury or disease subject to the additional medical care becomes worse than the time when the injury or disease is cured, not the case where the state of the injury or disease subject to the additional medical care becomes worse than the time when the injury or disease is cured, or other reasons other than the work.”