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(영문) 서울고등법원 2016.09.27 2016누39223
요양급여불승인처분취소
Text

1. The plaintiff's appeal is dismissed.

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

The purport of the claim and appeal is the purport of the appeal.

Reasons

1. Details of the disposition;

A. From November 28, 2014 to B (hereinafter “Nonindicted Company”), the Plaintiff served as a studio installer in Company B (hereinafter “Nonindicted Company”) on December 31, 2014, and went to H dan with Nonparty Company’s employees, and was crashed in the stairs of the danran bar building (hereinafter “instant accident”), and was diagnosed as “cerebrovascular out of brain, saloneone, thalone, cerebralone, and cerebral one (hereinafter “the instant accident”), and applied for medical care benefits to the Defendant on January 14, 2015.

B. On April 15, 2015, the Defendant rendered a disposition not to grant medical care to the Plaintiff on the ground that “The instant accident that occurred while the instant one-time hall was completed and the first place was moved to a two-lane entertainment place, not a business owner, on the ground that the overall process cannot be seen as being controlled or managed by the business owner, and it is difficult for the Plaintiff to view it as an “accident during the event” as an “accident during which the business owner was supervised or participated in the direction of the business owner.”

[Ground of recognition] Facts without dispute, Gap evidence Nos. 1, 3, 4, 11, and the purport of the whole pleadings

2. Whether the instant disposition is lawful

A. On the day of the Plaintiff’s assertion, the instant ceremony, which the Plaintiff attended, was not only a first meal and second class ran tavern from the first week to the second class dan under the supervision of the head of C division who was delegated by the business owner to hold a meeting and use the corporate card, and all of its expenses were paid by the company. As such, it is reasonable to deem that the instant ceremony was an event necessary for the labor management of the company, and the instant ceremony that occurred in the process constitutes occupational accident, and thus, the instant ceremony’s disposition based on the different premise is unlawful

(b) Determination 1 is affected by a disaster while participating in an event or a meeting that is not provided as a matter of duty to be ordinarily engaged in by an employment contract;

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