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(영문) 창원지방법원 2018.05.30 2017구단10020
요양급여불승인처분취소청구의소
Text

1. The plaintiff's claim is dismissed.

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

Reasons

1. Details of the disposition;

A. On March 18, 201, while serving as a staff member of the Plaintiff on March 2, 201, the Plaintiff was diagnosed on May 12, 2016, on the ground that there was a cerebral laf, old disorder, etc. (hereinafter “the instant injury”). On May 2, 2016, the Plaintiff filed an application for medical care benefits with the Defendant on June 29, 2016.

B. Accordingly, on August 29, 2016, the Defendant rendered a disposition of medical care benefit payment (hereinafter “instant disposition”) to the Plaintiff on the ground that “The proximate causal relation between the instant branch’s business and the instant branch is not recognized.”

C. The Plaintiff, who is dissatisfied with the instant disposition, filed a request for reexamination with the Industrial Accident Compensation Insurance Reexamination Committee, but on November 17, 2016, rendered a judgment dismissing the Plaintiff’s request for examination.

[Ground of recognition] Facts without dispute, Gap evidence Nos. 1, 2, and 3, the purport of the whole pleadings

2. Whether the disposition is lawful;

A. The Plaintiff’s assertion that the injury and disease of this case occurred during work hours, and the Plaintiff was subject to mental stress due to the company’s unfair personnel management order, and the disposition of this case, which acknowledged the relevance of work, was unlawful.

B. (1) Determination is that “occupational accident” under Article 5 subparag. 1 of the Industrial Accident Compensation Insurance Act refers to an accident resulting from an employee’s occupational performance while performing his/her duties, and there is a proximate causal relationship between the employee’s occupational and the accident. In such cases, the causal relationship between the employee’s occupational and the accident must be attested by

Although proximate causal relation is not necessarily required to be clearly proved by direct evidence, it should be proved to the extent that the proximate causal relation between work and accident is likely to be inferred by indirect facts, such as the health condition at the time of employment, existence of existing diseases, nature of work engaged, work environment, etc. based on the health and physical conditions of the relevant worker.

Supreme Court Decision 2014Du12185 Decided August 30, 2016, etc.

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