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(영문) 서울행정법원 2016.12.06 2016구합71553
건강보험 피부양자 자격 소급인정 청구의 소
Text

1. The instant lawsuit shall be dismissed.

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

Reasons

1. Case history

A. The defendant is an insurer of the health insurance, who is in charge of affairs such as management of the eligibility of the insured and their dependents, imposition and collection of the insurance premiums and other dues under the Health Insurance Act, management of the insurance benefits, payment of such expenses, etc.

B. On June 1, 2004, the Plaintiff was subject to each of the National Health Insurance Act from the self-employed insured as the self-employed insured, and from the self-employed insured as the dependent of the self-employed insured on March 11, 2015.

C. From November 2013 to March 2015, the Defendant imposed a total of KRW 3,021,710 on the Plaintiff as an individually provided policyholder for health insurance and long-term care insurance, and the Plaintiff paid the insurance premium accordingly to the Defendant every month.

[Ground of recognition] Facts without dispute, entry of evidence Nos. 1 and 2, purport of the whole pleadings

2. The Plaintiff’s assertion was employed on December 26, 2012 and became an employment provided policyholder for health insurance, and the Plaintiff did not have business income since 2012, and thus, the Plaintiff was qualified as a dependent of a child from the time when she became an employment provided policyholder.

In addition, the proviso of Article 2(4) of the Enforcement Rule of the National Health Insurance Act provides that the National Health Insurance Corporation shall not submit a report in cases where it can verify a person eligible to acquire or lose his/her eligibility as a dependent as data provided by the State, etc. pursuant to Article 96 of the National Health Insurance Act. In November 2013, the Defendant knew that he/she was provided with income data from the

Therefore, from the time the Defendant received income data from the National Tax Service from the Plaintiff, it should be deemed that the Plaintiff acquired the eligibility of the Plaintiff’s dependent as the health insurance policyholder.

Therefore, the defendant should be recognized retrospectively in November 2013 as a dependent on the plaintiff's insured status as a dependent on the plaintiff's insured status from November 2013 to March 2015 on the premise that the plaintiff is an individually insured person.

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