In cases where an insurer or an insurer’s organization urged a medical institution to pay unjust enrichment or additional dues pursuant to Articles 45, 55, and 55-2 of the former Medical Insurance Act, and then urged the same contents again, whether the latter demand is an administrative disposition subject to appeal litigation (negative)

According to Articles 45, 55, and 55-2 of the former Medical Insurance Act (amended by Act No. 4728 of Jan. 7, 1994), an insurer or an insurer’s organization may collect an amount equivalent to the expenses for insurance benefits from a medical institution that received insurance benefits costs by fraud or other unlawful means. If the medical institution fails to pay the money by the designated payment deadline in the payment notice, it may be forced by the procedure for default of national taxes. If the insurer or the insurer’s organization urged the payment of unjust enrichment or additional dues again after the payment notice was issued by the payment deadline, it shall be subject to an administrative disposition for which only the first demand is the object of an appeal as a collection disposition, and the same demand thereafter shall be subject to an administrative disposition for collection, which is merely a mere peremptory notice under the Civil Act, which is not a ground for interruption of extinctive prescription, but merely has a direct influence on the rights and obligations of citizens

Articles 45 (see current Article 45), 55 (see current Article 56), 55-2 (see current Article 57), 67 (see current Article 71), 71 of the Medical Insurance Act, Article 1 of the Administrative Litigation Act, Article 2 (1) 1, and 4 of the former Medical Insurance Act (Amended by Act No. 4728, Jan. 7, 1994);

Supreme Court Decision 86Nu147 delivered on October 28, 1986 (Gong1986, 3139) Supreme Court Decision 93Nu21156 delivered on February 22, 1994 (Gong1994Sang, 1116) Supreme Court Decision 94Nu514 delivered on October 28, 1994 (Gong194Ha, 3142)

Plaintiff

Medical Insurance Federation (Law Firm Bag, Attorneys Noh Jeong-eng et al., Counsel for the defendant-appellant)

Seoul High Court Decision 96Gu10968 delivered on November 21, 1996

The appeal is dismissed. The costs of appeal are assessed against the plaintiff.

The grounds of appeal are examined.

According to the provisions of Articles 45, 55, and 55-2 of the former Medical Insurance Act (amended by Act No. 4728 of Jan. 7, 1994; hereinafter referred to as the "former Act"), an insurer or an insurer organization may collect an amount equivalent to the expenses for insurance benefits from a medical institution for which the insurer or the insurer organization received the expenses for insurance benefits by deceit or other unlawful means. If the medical institution fails to pay the money by the designated payment deadline in the notice of payment, it may be forced to collect national tax in arrears procedures. If the insurer or the insurer organization urged the payment of unjust enrichment or additional dues and makes the same demand again after the same demand, it shall be an administrative disposition subject to appeal as only the first demand, and the same demand thereafter shall be a collection disposition, which is a prerequisite for disposition of arrears, and shall not affect directly the rights and duties or legal status of the people. Thus, it shall not be subject to appeal litigation.

The judgment of the court below is just and acceptable in accordance with the above legal principles, and there is no error in the misapprehension of legal principles as to administrative disposition subject to appeal litigation. The ground of appeal on this point cannot be accepted.

The remaining grounds of appeal are based on the premise that the demand of this case is an administrative disposition subject to appeal, so long as the court below did not recognize the administrative disposition of the demand of this case, it shall not be deemed that there is an error of law as otherwise alleged in the grounds of appeal by the court below, on the ground that the court below did not determine

Therefore, the appeal is dismissed, and the costs of appeal are assessed against the losing party. It is so decided as per Disposition by the assent of all participating Justices on the bench.

Justices Seo Sung-sung (Presiding Justice)