1. Revocation of a judgment of the first instance;

2. The Defendant’s unjust enrichment amounting to KRW 3,734,890 against the Plaintiff on November 8, 2013.

1. Details of the disposition;

A. On March 15, 2013, the Plaintiff, the insured of the Defendant’s health insurance, was in excess of the driver’s license for a motorcycle in the vicinity of the bridge located at the high-speed Myeong-si, Leecheon-si without a motorcycle driver’s license on March 15, 2013

(hereinafter “instant accident”). B.

The Plaintiff suffered from injury, such as a ductal and analone framework, which is obscure in detail due to the instant accident, and received treatment at B Hospital, etc., and the Defendant provided insurance benefits of KRW 3,734,890 for the Plaintiff’s injury from March 16, 2013 to June 19, 2013.

C. On November 8, 2013, the Defendant issued a disposition to recover insurance benefits of KRW 3,734,890 already paid to the Plaintiff, the insured, as unjust enrichment, pursuant to Articles 53(1) and 57(1) of the National Health Insurance Act, on the ground that the instant accident was attributable to the Plaintiff’s non-licensed driving and breach of the duty of care for safe driving (hereinafter “instant disposition”).

[Reasons for Recognition] Evidence No. 1, Evidence No. 1, Evidence No. 1, and the purport of the whole pleadings

2. Determination on the legitimacy of the instant disposition

A. The gist of the Plaintiff’s assertion is that the Plaintiff was driving without obtaining a license.

However, in light of the legislative intent of the National Health Insurance Act, the requirements for restricting benefits under Article 53 (1) should be strictly interpreted.

Therefore, only one of the grounds for restrictions on insurance benefits cannot be deemed to constitute “a criminal act caused by intention or gross negligence or an intentional accident.”

Therefore, the instant disposition made on a different premise is unlawful.

(b) The details of the relevant statutes are as shown in the attached statutes.

C. Article 53(1)1 of the National Health Insurance Act provides that insurance benefits shall be limited to cases where a criminal act is committed by intention or gross negligence, or an insured incident is intentionally caused.