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(영문) 창원지방법원 2015.01.06 2014나32254
부당이득금
Text

1. The part against the plaintiff corresponding to the money ordered to be paid under the judgment of the court of first instance shall be revoked.

2...

Reasons

1. Basic facts

A. On December 24, 2009, A, an insured under the National Health Insurance Act, was provided medical treatment at a medical care institution, such as Samsung Seoul Hospital, after suffering from an injury to cerebrovascular, etc., during which he/she had worked in a genetic precise corporation. From January 24, 2010 to October 1, 2010, the Plaintiff paid KRW 27,215,170, the remainder of A’s medical expenses incurred during the above period, excluding the principal’s share, to the medical care institution.

B. On July 19, 2013, the Defendant rendered a decision to approve industrial accidents against A.

C. Article 53(1)4 of the National Health Insurance Act provides that “Where a person eligible to receive insurance benefits receives insurance benefits or compensations under other statutes due to a disease, injury, or accident that occurred on duty, the Plaintiff shall not provide insurance benefits.” The relevant provisions of the Industrial Accident Compensation Insurance Act (hereinafter “Industrial Accident Insurance Act”) are as follows.

Article 40 (Medical Care Benefits) (1) Medical care benefits shall be paid to any worker who suffers from an injury or disease due to his/her occupational reason.

(2) Medical care benefits referred to in paragraph (1) shall be provided to industrial accident insurance-related medical institutions referred to in Article 43 (1).

Provided, That where it is inevitable, medical care expenses may be paid in lieu of medical care.

(1) A person who applies for medical care benefits pursuant to Article 41 (1) may receive medical care benefits or omissions under Article 41 of the National Health Insurance Act before the Korea Workers' Compensation and Welfare Service makes a decision on medical care benefits under this Act.

(1) Where the National Health Insurance Corporation under Article 13 of the National Health Insurance Act or a person entitled to medical care benefits under this Act preferentially pays health insurance, medical care benefits, etc. and claims such expenses pursuant to Article 42 (1), the Korea Workers' Compensation and Welfare Service may pay such health insurance, medical care benefits, etc. pursuant to this Act.

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