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(영문) 서울남부지방법원 2018.11.22 2017나59800
부당이득금
Text

1. The part against the defendant in the judgment of the first instance shall be revoked;

2. The plaintiff's claim against the defendant is dismissed.

3...

Reasons

1. Inasmuch as the date of payment of the medical expenses that the Plaintiff paid to the Defendant, the date of each review by the ordinary members of the ordinary members, the accurate reasons for restitution, etc. are not submitted, the fact is recognized within the scope of evidence submitted.

B, C, and D (hereinafter referred to as “B, etc.”) have received treatment of pharmacological surgery, etc. as a result of the Defendant’s “AB” operated by the Defendant after having suffered a traffic accident. The Plaintiff, as an insurer under the comprehensive automobile insurance contract, guaranteed the obligation to pay the above medical expenses.

B. From October 29, 2013 to January 2, 2014, the Defendant filed a claim for motor vehicle insurance medical fees with the Health Insurance Review and Assessment Service (hereinafter “Special Review Service”) under the relevant legal provisions, as seen below, against B, etc. for medical fees for motor vehicle insurance medical fees, and the ordinary appellate court rendered a review and decision that recognized the full amount of the medical fees claimed by the Defendant as the motor vehicle insurance medical fees (hereinafter “instant review and decision”).

The plaintiff did not raise an objection to the above review decision and paid the full amount of the medical expenses, B, etc. to the defendant.

C. However, on June 30, 2014, after examining ex officio the Defendant’s reimbursement of KRW 768,050 out of the medical expenses such as B, etc., the Prosecutor notified the Defendant of the aforementioned examination results (hereinafter “instant restitution notification”). D.

The statutes relating to the instant case shall be as follows:

(1) Where an insurer, etc. becomes aware of the occurrence of a motor vehicle accident patient by a policyholder, etc. or the victim under the latter part of Article 10 (1) or by any other cause, he/she shall, without delay, notify the medical institution that treats the relevant motor vehicle accident patient of whether he/she wishes to pay motor vehicle insurance medical fees and the payment limit thereof.

(2) Insurance companies, etc. under paragraph (1).

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