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(영문) 서울행정법원 2017.06.29 2015구합83672
산재요양급여비용환수처분 취소 등
Text

The Defendant’s disposition to recover the cost of industrial accident medical benefits provided to the Plaintiff on October 16, 2015 shall be revoked.

The costs of lawsuit.

Reasons

1. Details of the disposition;

A. The Plaintiff and B are both doctors.

B. C Hospital (hereinafter “instant hospital”) was established in the name of the Plaintiff on November 4, 201.

C. On December 30, 2014, the prosecutor of the District Public Prosecutor’s Office issued a disposition of suspending prosecution against B and the Plaintiff’s suspicion of violating the Medical Service Act against the Plaintiff to the effect that B, who had operated the D Hospital, conspired with the Plaintiff, had installed and operated the medical institution.

On March 30, 2015, the Plaintiff filed a constitutional complaint with the head of 2015Hun-Ma324 against the disposition of suspending indictment.

On April 30, 2015, the Plaintiff voluntarily closed the instant hospital.

E. On October 16, 2015, the Defendant rendered a disposition (hereinafter “instant disposition”) to collect the amount equivalent to the following amount of decision on collection from the Plaintiff based on Article 84(3)1 of the Industrial Accident Compensation Insurance Act, on the ground that “The instant hospital was established in violation of the standards for the establishment of a medical institution prescribed in Article 33(8) of the former Medical Service Act (amended by Act No. 13658, Dec. 29, 2015; hereinafter the same) and was not designated as an industrial accident insurance-related medical institution (hereinafter “industrial accident insurance”). However, the Plaintiff received designation of the instant hospital as an industrial accident insurance-related medical institution and received medical care for the affected workers, and received payment from the Defendant after claiming medical expenses as indicated in the table below and medical expenses for post-beatary gift (hereinafter “instant disposition”).

The amount of decision on the collection of unjust enrichment for the type of benefit 2,368,322,270 won 4,736,64,540 won 6,345,520 won for later legacy medical expenses 6,345,520 won / [based on recognition] without dispute, Gap evidence 1-4, Eul evidence 1-1, and Eul evidence 1, and the purport of the whole pleadings

2. Whether the instant disposition is lawful

A. The details of the relevant statutes are as shown in the attached statutes.

B. First, where an industrial accident insurance-related medical institution is a medical institution established in violation of Article 33(8) of the former Medical Service Act, claiming expenses incurred in relation to industrial accident medical care benefits provided at the medical institution is subject to Article 84(3)1 of the Industrial Accident Compensation Insurance Act.

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