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1. Of the judgment of the court of first instance, the defendant 2,00,000 won and its related thereto to the plaintiff from April 25, 2013 to April 9, 2015.
Reasons
1. Facts of recognition;
A. The Plaintiff entered into an insurance contract with B, etc. with the insured as 29 persons, such as B, etc. indicated in the “name of the insured” in the “name of the insured” list of damages, and entered into an insurance contract with the content that the insured is paid 80% or 100% of medical expenses when the insured was hospitalized in a hospital, etc. due to disease during the insurance period.
B. The Defendant, as the president of the “D Council member” in Ansan-si, Ansan-si, issued to B, etc. a certificate of entry and discharge with the content that he/she performed hospitalized treatment after the Mamomo-mom surgery during the period from January 28, 2009 to December 13, 2010.
C. B, etc. claimed insurance money against the Plaintiff on the ground of the certificate of discharge issued as above, and received each corresponding money indicated in the “insurance money” column in the attached Form List of Damages.
According to the "Detailed matters concerning the criteria and methods for the application of medical care benefits" publicly notified by the Ministry of Health and Welfare, the standard for calculating daily admission fees means a case where the maximum time is at least six hours in the "inpatient".
The patients with the major contents of aiding and abetting act, the amount of fraud by the insured (won) and the amount of 1 cm less than 1 cm are entitled to receive medical treatment since there is no need for continuous observation and management of the medical staff after the Maom surgery, but it is possible to receive medical treatment. However, the patients were hospitalized per day to attract the patients who purchased insurance products.
E 830,000 [Attachment 9] F 500,000 related to the list of damages Nos. 13 related G 580,000 G 13 related G 580,000 with 14 related Mamomomoto, however, the patient was hospitalized for one day, but the patient was hospitalized for two days.
B Related H 1 related H 30,000 Nos. 20,000 related I 20,000.