Escopics
Defendant 1 and 15 others
Appellant. An appellant
Defendants and Prosecutor
Prosecutor
B. dilution (prosecution), Kim Jae-ho, Lee Jae-ho, and Lee Jae-young (Trial)
Defense Counsel
Attorneys Kim Yong-sung et al.
Judgment of the lower court
Chuncheon District Court Decision 2014Gohap57 decided December 31, 2014
Text
Of the judgment of the court below, the part on Defendant 1, Defendant 2, Defendant 3, Defendant 4, Defendant 6, Defendant 7, and Defendant 16 shall be reversed.
Defendant 1, Defendant 3, and Defendant 7 are punished by imprisonment of one year and six months, by imprisonment of one year, Defendant 2, Defendant 4, and Defendant 6 by fine of 30,00 won, respectively, and Defendant 16 by fine of 10,00 won.
When Defendant 4, Defendant 6, and Defendant 16 do not pay each of the above fines, they shall be confined in a workhouse for the period calculated by converting each one million won into one day.
However, the execution of each of the above punishment shall be suspended for three years for Defendant 1, for two years for Defendant 3, Defendant 7, and Defendant 2 from the date this judgment became final and conclusive.
Defendant 4, Defendant 6, and Defendant 16 order the provisional payment of the amount equivalent to the above fine.
All appeals by Defendant 5, Defendant 8, Defendant 9, Defendant 10, Defendant 11, Defendant 12, Defendant 13, Defendant 14, and Defendant 15 and prosecutor’s appeals against the same Defendants are dismissed.
Reasons
1. Summary of the facts found by the court below
A. Status of the Defendants
Defendant 3, Defendant 4, Defendant 9, and Defendant 10 are the former and present head of the Incheon Do, the Do, the Do, the Bupyeong-gu, the Bupyeong-gu, the Gyeongbuk-gu, and the Eunpyeong-gu Hospital (hereinafter collectively referred to as the “Masan Hospital”); Defendant 5, Defendant 6, Defendant 7, Defendant 11, Defendant 12, Defendant 13, Defendant 14, and Defendant 15 are the former and incumbent head of the planning office (hereinafter collectively referred to as the “the Defendants on the side of the hospital”).
Defendant 1, Defendant 2, Defendant 8, and Defendant 16 are officers and employees of ○○○○ Shipbuilding Co., Ltd. (hereinafter “○○○○○”) (hereinafter “○○○”) who are entrusted meal service providers (hereinafter “instant Defendants”).
B. The portion of additional dues for in-patients in △ Hospital
The Defendants of the hospital, upon negotiating terms and conditions of the consignment agreement on the operation of the restaurant with the Defendants on the side of the hospital, agreed that the ○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○, etc., shall be placed under the hospital only in the form of a dietitian, a cook, a cook, and a cook, who is required to receive the instant additional dues (hereinafter referred to as the “instant additional dues”), and the personnel expenses shall be borne by the ○○○○○○○○○○○○○○○○○, etc., on the basis of subsequent management and maintenance expenses, the ○○
As such, although the dietitians, etc. failed to meet the requirements for the supply and demand of the instant additional dues because they could not actually belong to the △ Hospital, the Defendants conspired to employ them directly and have them bear the actual expenses, such as personnel expenses, etc., and the Defendants led and supervised them. In addition, as if the cook did not actually work on the job, the Defendants filed a claim for the additional dues of this case with the Health Insurance Review and Assessment Service by pretending that they had actually worked on the job, thereby allowing the victims to issue the instant additional dues to the victims according to the results of the assessment by the Health Assessment and Assessment Service, and allowing the medical care patients (hereinafter “victims”), who are victims, to pay the patients’ own charges corresponding
C. The portion of additional dues on food for patients in △△△△ Hospital, △△ Hospital, and △△ Hospital
The executive officers and employees of △△△△△ Hospital, △△△△ Hospital, △△△ Hospital, and △△△△ Hospital are in the form of a dietitian, etc. necessary to receive the additional dues of this case in the course of negotiating terms and conditions of an entrustment contract on the operation of △△△△△ Hospital, and △△△△ Hospital. The personnel expenses therefrom shall be borne by ○○○○○ Group, not a hospital, but a hospital. On the other hand, when the hospital pays the benefits, etc., it agreed to have the dietitian, etc. employed under the hospital, etc. assist in the entrusted management work of ○○○○○ Group.
As such, although the dietitians, etc. do not actually belong to the above hospital and do not meet the requirements for the supply and demand of the surcharge of this case, the Defendants, in collusion with the officers and employees of the above hospital, employed them directly at the hospital and charged them with the actual expenses, such as personnel expenses, etc., and filed a claim for the additional surcharge of this case, which is pretended to be directed and supervised by the above hospital, thereby allowing the victim to deliver the additional charge of this case to the National Health Insurance Corporation according to the results of the evaluation of the Health Insurance Review and Assessment Service (the amount obtained by Defendant 1 to the victim through the △△△△△△△ Hospital is KRW 614,489,320), and the affected patients to pay the patient's own share equivalent to the additional charge of this case, thereby obtaining the insurance benefits from the victim by unlawful means in collusion with the officers and employees of the above hospital.
2. Summary of grounds for appeal;
A. misunderstanding of facts or misunderstanding of legal principles
(1) unspecified (○○○ Defendants) of the facts charged
Among the facts charged in the instant case, the fraud that acquired the goods from the medical patients constitutes separate crimes for each of the patients. Therefore, even though the damaged patients and the damaged amount should be specified individually, the prosecutor did not enter the personal information of the damaged patients or the individual damages in the indictment at all, and entered only the damaged patients by hospital and period.
Therefore, among the facts charged in the instant case, each fraud of the victimized patients is not properly specified in the facts charged, and the indictment procedure is null and void in violation of the provisions of the law, and thus, this part of the indictment should be dismissed in accordance with Article 327 subparagraph 2 of the Criminal Procedure Act
(2) Meeting the requirements for payment of additional dues (the defendant)
Although ○○○○○○○○○○○○○○○○ was later paid an amount equivalent to personnel expenses for dietitians, etc. to the Do○○ Hospital, △△△△△ Hospital, △△△ Hospital, △△△△ Hospital, and △△△△ Hospital (hereinafter collectively referred to as “entrusted hospital”), the entrusted hospital, regardless of such economic support, has concluded an employment contract with dietitians, etc. with genuine will as well as had it practically direct and supervise them and check the quality or nutritional conditions of the meal service, regardless of such economic support, the relevant affiliated hospital is not the ○○○○○○, but the entrusted hospital. Therefore, the entrusted hospital
(3) Non-existence of the criminal intent by fraud (the defendant)
Even if the claim for the instant additional dues is unlawful because it cannot be viewed as a family dietitian, etc. as the jurisdiction of the entrusted hospital, in the situation where there has been no clear guidelines for determining the affiliation of dietitians, etc. so far, the Defendants thought that the dietitians, etc. employed by the entrusted hospital would belong to the hospital even if they comply with the requirements for the payment of the instant additional dues, and thus, the Defendants did not have any subjective intent to acquire property by deceiving the Health Insurance Review and Assessment Agency, i.e., fraud., fraud.
(4) The suspension of crimes following the dispatch abroad (Defendant 1)
From May 16, 2011 to October 16, 201, Defendant 1 transferred to general affairs, which is ○○○○, China, for five months from May 16, 201, and worked in the field of China. In this case, even if Defendant 1 is found guilty of all the crime of acquiring the additional charges of this case, Defendant 1 ceases to have committed fraud with the Chinese service and cannot recognize the identity or continuity of the criminal intent between the crimes before and after the Chinese service. Therefore, the crime before and after the crime is only a substantive concurrent crime and cannot be a single crime. Accordingly, if calculating the amount of profit from the crime before and after the Chinese service, the amount acquired through the △△△△△△ Hospital is less than 50 million, and thus, the crime of violating the Act on the Aggravated Punishment, etc. of Specific Economic Crimes (Fraud) cannot be established.
(5) Subject matter of regulation under Article 115(2)5 of the National Health Insurance Act (Defendant 1, Defendant 2, and Defendant 16)
Article 115 (2) 5 of the National Health Insurance Act provides that Article 115 (2) of the same Act applies to cases where “patients using health care institutions, such as the insured or his/her dependent, has received or had another person receive insurance benefits by fraudulent or other unlawful means, such as unlawful use of the health insurance card, and medical care institutions claiming “insurance benefit costs” rather than “insurance benefits costs” do not constitute subject to the provisions of the same Article. Therefore, even if Defendant 1, 2, and 16 conspired with the officers and employees of △△△△△△, △△△ Hospital, and △△△ Hospital, and △△△ Hospital, even if they received the “insurance benefits costs” unfairly in collusion with those officers
B. Unreasonable sentencing
(1) Defendants
The sentence of each judgment of the court below (the sentence of the defendant 1: 2 years of imprisonment; 1.6 months of imprisonment; 3 years of probation; 5 years of imprisonment; 2 years of probation; 1.6 years of probation; 2 years of probation; 3 years of probation; 4 years of probation; 3 years of probation; 6 years of probation; 9; 10 million won of a fine; 20 million won of a fine, 11, 12, 13, 15; 16; 14 million won of a fine; and 12 million won of a fine) is too unreasonable.
(2) Prosecutor
The sentence imposed by the court below against the Defendants is too unhued and unreasonable.
3. As to the violation of the Act on the Aggravated Punishment, etc. of Specific Economic Crimes (Fraud) and fraud
A. Whether the facts charged are lawful
(1) The specific legal doctrine of the facts charged
Article 254(4) of the Criminal Procedure Act provides that the facts charged shall be specified by specifying the time, date, place, and method of a crime (Article 254(4) of the Criminal Procedure Act). This is sufficient to specify the facts constituting the element of a crime to the extent that the defendant can easily exercise his/her right to defense. As such, the facts charged are integrated to the extent that the facts constituting the crime are distinguishable from other facts. Even if the date, time, place, method, etc. of a crime are not specified in the indictment, it does not go against the purport of the Act providing for the specification of the facts charged, in light of the nature of the crime, and if it is inevitable to indicate the facts charged, and it does not interfere with the defendant’s exercise of his/her right to defense (see, e.g., Supreme Court Decisions 2013Do1615, Apr. 10, 2014; 2010Do4671, Aug. 2
(2) Determination
It is true that the prosecutor does not specify the personal information for each damaged patient and not separately describe the amount of fraud for each damaged patient in the facts charged while instituting the crime of defraudation of the victimized patients by the defendants, but makes the total sum of the amount of defraudation for the damaged patients by hospital and period (one month).
However, in this part of the facts charged, the prosecutor shall specify the category (patient who has been provided with meals at the entrusted hospital) of the victimized patients, the time, method, and method of calculating the amount of fraud, etc., and if necessary, the entrusted hospital can easily understand the personal information of the victimized patients and the amount of fraud by the individual, and even if it is not individually recorded in the facts charged, it is also possible to verify the accuracy of the amount recorded as above through the data such as the account books kept by itself. Thus, it cannot be said that the entry in the facts charged is difficult to exercise the defendants' right of defense. In particular, since the number of victimized patients is about 40,000 won, it is obvious that the number of victimized patients is considerably difficult to record their personal information, etc. in daily documents. On the other hand, as seen earlier, it is difficult to see that the Defendants are closely related to the personal information of the victimized patients or the amount obtained by deception, such as there is no deception or there is no criminal intent, and thus, it is also difficult to regard that they are aware of their personal information and the amount of defense rights.
In light of the above circumstances, it is inevitable to comprehensively indicate the personal information and the amount of the fraud for the victimized patients among the facts charged in the instant case, and it does not interfere with the Defendants’ exercise of their right to defense, and thus, it can be deemed that the prosecutor specified the facts charged to the extent sufficient for the prosecutor to examine the case. The assertion by the Defendants on the other ○○ side of the instant case is rejected.
(b) Staff members of dieticians, etc.;
(1) Issues
According to Article 41(2) of the National Health Insurance Act and Article 8(2) of the Regulations on the Standards for Medical Care Benefits under National Health Insurance (Ordinance of the Ministry of Health and Welfare), “the act of health insurance and its relative value” (Notice of the Ministry of Health and Welfare No. 2006-37 of the Ministry of Health and Welfare) of the Ministry of Health and Welfare shall be calculated according to the number of full-time dietitians or cooks belonging to the relevant health care institution; and (1) the additional dues of this case, including dietitians, may be applied to cases where two or more group of meals are provided each day to make an in-patient selected under the premise that at least one dietitian belonging to the relevant
A prosecutor only entered into a formal employment contract with dietitians, etc., but actually ○○○○○○○, etc., in the course of directing and supervising the dietitians, etc., and thus, did not meet the requirements for the additional payment of the instant surcharge that he/she should belong to the medical care institution, thereby instituting the instant public prosecution. On the other hand, the Defendants asserted that the dietitians, etc. actually worked in the hospital and denied the crime.
As a result, this case's additional dues should be paid to the dietitians, etc. who signed an employment contract with the entrusted hospital. Therefore, this case's additional dues should be examined.
(2) Legal principles
(A) The significance and significance of the additional dues
The government newly established the additional dues system in order for the medical care institution to compensate for additional inputs (wages, human resources management expenses) incurred in employing dieticians, etc. under its control (see the opinion of the Minister of Health and Welfare among the Constitutional Court Decision 2006Hun-Ma90, Apr. 24, 2008) on the basis of a policy judgment that, if a dietitian, etc. employed by the medical care institution directly under its control exists in the case of a dietitian, etc., he/she will enhance his/her sense of responsibility, sense of sense of duty, and sense of duty, as well as to maximize profits from the management policies of private entrusted food service enterprises that intend to maximize profits.
(b) Basic requirements
In light of the purport of the introduction of the instant surcharge system, it is difficult to see that a medical care institution such as a hospital, etc. has concluded a labor contract with a dietitians, etc. as a matter of course, and furthermore, it is possible to pay the instant surcharge only when it is recognized that the relevant dietitians, etc. were in service with a medical care institution. Here, whether a dietitians, etc. are affiliated with the relevant medical care institution ought to be determined not by a formal labor contract but by “whether a medical care institution has actually employed, directed and supervised them” (see Supreme Court Decision 2013Do13673, Jun. 26, 2014).
(C) Division from civil employment relationship
In addition, considering the fact that the requirements for the payment of the instant additional dues are not “employment” but “affiliated” rather, and the purport of the system is to improve the quality of meal service and quality in the direction favorable to the medical care institution by a dietitian and cook who belongs to the medical care institution independently from the private entrusted meal service company, even if a valid employment contract under civil law was concluded, if the medical care institution does not actually direct and supervise dietitians, etc., it may not be deemed that the requirements for the payment of the additional dues are satisfied. In addition, the Act on the Protection, etc. of Temporary Agency Workers, etc. of Temporary Agency Workers, defines the term “worker dispatch” as “where a temporary work agency employs a worker after it has employed a worker, and has him/her work for the using company under the direction and order of the user company in accordance with the terms of the contract on temporary agency, while maintaining the employment relationship with a dietitian, even if the staff of the medical care institution who has lawfully concluded the employment contract with the medical care institution, they cannot be deemed as a dietitian or cook belonging to the relevant medical care institution.
Therefore, only confirming whether a medical care institution has entered into a valid employment contract with a dietitian cannot determine whether it satisfies the requirements for additional dues. In addition, as seen below, the location of the relevant dietitian, etc. in the school meal service of the medical care institution should be determined based on whether it is included in the direction and supervision system of the medical care institution or its functional location in the school meal service regardless of the employment contract is included in the direction and supervision system of the entrusted meal service company.
(d) the necessity and criteria of functional affiliation in meal service operations
To improve the service and quality of meal services by having a dietitian, etc. directly employed by a medical care institution take charge of meal services is the main purpose of introducing the instant additional dues system, and the core duties, such as dietitians, are to provide meal services. Therefore, in the area where a dietitian employed by a medical care institution is required to practically direct and supervise dietitians, etc., and if he/she fails to command and supervise them in the meal service, he/she can not be deemed to have a relation that is the premise for the payment of the instant additional dues, even if he/she can be recognized in other aspects, such as the announcement of personnel affairs or the payment of wages, etc. (in addition to the meal service affairs, indirect circumstances may be taken into account to determine the existence of command and supervision relationship in the meal service business).
However, in the case of meal services in a hospital consisting of the preparation of a food group, orders for food materials, food cooking, distribution, etc., and thus, the dietitians, etc., who have concluded an employment contract with an entrusted hospital in the course of performing such a series of meal services have been subject to direct and supervision by the hospital independently from the entrusted hospital in the process of performing the relevant duties, or is subject to the direction and supervision by the ○○○○ Shipbuilding, or is subject to the direction and supervision by the ○○○ cook, and whether he/she has been engaged in the relevant duties in a separate position from other employees of the ○○○○ Shipbuilding meal Service Department.
As to this, the Defendants asserted that it is inevitable in light of the nature of entrusted operation to take charge of the work such as preparing a basic camera and ordering food materials in ○○○ Shipbuilding, and to give instructions to a hospital employees, etc. within a certain scope. However, this is contrary to the purport of introducing the additional dues system in this case, and it is reasonable to view that if the dietitians, etc. actually belong to the hospital, it is not possible to give instructions to work in a superior position even if they request cooperation from the hospital, and therefore, the Defendants’ above assertion is groundless.
(3) Determination
According to the evidence submitted by the Defendants, △ Hospital: (a) prepared a personnel report in the course of new employment and extension of a contract for dietitians; (b) received a letter of assistance directly from the applicants; and (c) after employment, the applicants of the Gangnam-gu, the Gangwon-gu, the Gangwon-do, and the Gyeongcheon Hospital entered the employment support hospital into the employment support hospital in the employment support plan; and (d) drafted the premise on the premise that they were employed in the △ Hospital; (b) it can recognize the fact that the hospital conducted personnel evaluation, personnel management, etc. of dietitians, like other employees of the hospital; and (c) comprehensively taking into account these facts, it can be acknowledged that the hospital entered into a civil binding employment contract with the dietitians initially employed by the △ Hospital. However, notwithstanding the effective employment relationship based on the evidence duly adopted and investigated by the lower court, the assertion that the relevant dietitians et al. were functionally located in the school meal service, not in the entrusted hospital, but in the direction and supervision system of the ○○○ Hospital could not be accepted.
(A) Nonindicted 3’s statement by the Director of △△△ Hospital
After concluding an entrustment contract on the operation of a cafeteria in a way similar to the entire entrusted hospital in a manner similar to the whole, the ○○○○○○○○○○○○○○ Hospital made use of it for its own meal service bypassing the benefits of the employees of the hospital as the cost of management and maintenance. Nonindicted 3, the head of the hospital at △△△△△△△△ Hospital, one of the entrusted hospitals, accepted the proposal of ○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○○’
(b) Employment and payment of wages;
A commissioning hospital did not decide on the dietitians, etc. to be employed in accordance with its own criteria and procedures to exclude the involvement of ○○○ Shipbuildings, but rather, the head of ○○○○ Shipbuildings de facto decided who will work for the applicants for preferential membership through interviews with the applicants for preferential membership, etc., and subsequently, the hospital conducted employment procedures by entering into an employment contract with the relevant dietitians, etc. In particular, ○○○○ Shipbuilding paid the amount equivalent to the salaries paid to the dietitians, etc. according to a special agreement entered into with the relevant entrusted hospital again to the relevant hospital under the pretext of management and maintenance expenses. As a matter of course, it did not exercise the authority to direct and supervise the dietitians, etc. (i.e., participating in the recruitment process of the dietitians, etc., and (ii) if the dietitians, etc. were in an independent position from the ○○○○ Shipbuilding, it can be an important standard for determining whether they belong to the dietitians, etc.).
(C) a general authority to direct and supervise work;
○○○○○○○ Ordinance on the Promotion of the Business Department of Food and beverage Services (Fodice) and Nonindicted 1 delivered to Defendant 8, on February 15, 2007, stated that “it is essential to be employed as a party to the present special circumstances for the current personnel. It is possible to manage the human resources belonging to the hospital. Then, the head of the ○○○○ Ordinance small division and Nonindicted 2 stated that “it is possible to pay additional gift to the human resources belonging to the hospital.” In order to apply the food and medical insurance benefits of the hospital, two and three dieticians belonging to the hospital are employed and two or three cooks belonging to the hospital for the purpose of applying the food and medical insurance benefits of the hospital, and during the same work in the same space as the cooking personnel belonging to the hospital (on the part of the hospital’s personnel expenses) under the direction and direction of the above staff at the time of the first contract with the hospital, the head of the ○○ Ordinance and Nonindicted 2 stated that he is in the form and direction of the cook.”
(d) Command and supervision, such as the preparation, order management, cooking, etc. of a group;
The restaurant New Hospital basically decided by the ○○○○○○○ Branch in charge of six hospitals affiliated with △ Hospital, through a Meet meeting, and during this process, the hospital employees’ dietitians did not play any role.
On the other hand, there may be some changes in the process of implementing the basic domain new as above, depending on the individual circumstances of the relevant hospital. In such a case, ○○○○○○ department decided whether to revise the main draft of the hospital, and even if the draft draft of the hospital employment dietitian, the hospital employees, etc. did not have a substantial right to make decisions on the method of meals and cooking, such as the right to obtain approval from the captain of the point of view, as well as the right to speak.
In other words, if it is deemed that the dietitians, etc. employed by the hospital have led the school meal service by functionally belonging to the hospital, the dietitians, etc. should decide the food group and cooking method under the direction and supervision of the officer and staff of the hospital, and even if the ○○○ Ri boat prepares the draft draft of the hospital, the right to final decision should be reserved by allowing the employees of the hospital to obtain approval from the dietitians, etc. of the hospital with regard to whether to accept the draft of the hospital, etc., as well as by allowing them to produce and provide information to support the maintenance of the contract relationship of the entrusted meal by regularly evaluating the quality and appropriateness of the quality of the entrusted meal service and to report it to the hospital. However, the dietitians, etc. employed by the entrusted hospital rather than by the ○○ Ri Ri department's employees, etc. engaged in the school meal
(e)education for hospital employees, etc. and bearing of their expenses;
In ○○○ Liart, the employees of hospitals were also engaged in the education of dietitians, etc. on the ability to improve the occupational group and duties of hospital in 201, the education of the occupational group and ability to improve duties of hospital employees in 2012, and the education of in-house and in-house training for the cultivation of nutritions of hospital employees in 201, as well as the education of dietitians, etc. (in case that the employees of hospital employees, etc. who are required to engage in the school meal service independently from ○ Liart received the education in ○○ Liart, it cannot be deemed that it is practically difficult to play the leading role in the school meal service in accordance with the purport of introducing the additional dues system in this case).
(f)Other detailed circumstances
If a dietitian, etc. employed by an entrusted hospital actually under the direction and supervision of the ○○○○ Shipbuilding with respect to the meal service, and arranging the detailed circumstances that may be known that he/she had worked for the meal service system for each hospital, it shall be as specified in the detailed conditions of each hospital.
(4) Regarding the circumstances alleged by the Defendants
The Defendants asserted that the employees of the hospital were actually affiliated with the entrusted hospital and that they were the basis thereof, and suggested that ① prepare a personnel report in the course of the new recruitment and extension of the contract of dietitians, etc., ② received the support directly from the applicants, ② paid the amount to be borne by the users out of the four major insurance for dietitians, etc. ③ the head of the planning office of the entrusted hospital stated the evaluation score and evaluation table on dietitians, etc. ③ The head of the planning office of the entrusted hospital was able to access the internal network of the entrusted hospital by being assigned the numbers of the staff of the entrusted hospital, ④ the dietitians, etc., unlike the ○○ research team staff, and ⑤ the regulations related to the leave of the entrusted hospital rather than the ○○ research team, and the annual application was carried out through the computer system of the entrusted hospital itself.
However, such circumstances are most of the procedures or results naturally accompanying the conclusion of employment contract, and it is not reasonable to view that dietitians, etc. were engaged in meal service in the direction and supervision system of the entrusted hospital independently from the entrusted hospital rather than simply entering into an employment contract valid legally with the entrusted hospital. Even if an officer or employee of the entrusted hospital, such as the head of the family planning office, etc. gives instructions on meal service to the dietitians, etc. intermittently, as seen earlier, the entrusted hospital finally decides new technology through the dietitians, etc. or does not have any means to evaluate the level of meal service or the appropriateness of the price of meal service, in light of the fact that the entrusted hospital, as seen earlier, does not have any means to evaluate the appropriateness of meal service, such sporadic instructions can be deemed as treating dietitians, etc. as one of the members of the 00 cooking meal service department, and therefore, they cannot affect the judgment of the front day that they belong to the 00 cooking group in terms of the function of meal service business.
(c)whether the person has committed fraud or not;
(1) Legal principles
The intent of the crime of defraudation, which is a subjective constituent element of fraud, shall be determined by comprehensively taking into account the objective circumstances, such as the Defendant’s financial history, environment, details of the crime, and the process of performing the transaction before and after the crime, insofar as the Defendant does not confession. On the other hand, the crime of fraud may be established not by conclusive but by willful negligence. The possibility of the occurrence of the crime is recognized, and furthermore, the intention of deliberation to allow the risk of the crime is required (see, e.g., Supreme Court Decisions 2007Do10416, Feb. 28, 2008; 2008Do443, Mar. 27, 2008).
(2) Determination
The lower court duly admitted and examined the following circumstances: ① the Defendants did not directly indicate the terms and conditions of the agreement to bear personnel expenses of dietitians, etc. in the consignment operation contract; ② the Defendants received them bypass through the account called “management and maintenance expenses” which is no superior with the original purpose; this cannot be deemed to have been attributable to the intent to conceal the fact of funding for 00 cooking, such as that the relevant amount would not appear as personnel expenses in the accounts of the consignment hospital and ○○○○○○, and ② the ○○○○○○○○○○○, upon the request of the Defendants for the recruitment of dietitians, etc., which could have been demanded by the consignment hospital in accordance with the patient-based insurance benefits; ② the Defendants could not be seen as having been aware of the aforementioned demand for the issuance of additional dues to the public prosecutor’s office, which would have been contrary to the initial demand for the provision of additional dues, and subsequently, would not have been able to have any problem in the structure of the aforementioned consignment.
D. Whether an inclusive crime is committed
(1) Legal principles
Where multiple acts constituting the same element of crime continue to be committed for a certain period of time with a single and continuous criminal intent and the benefit and protection of the law from such damage are identical, each of these acts shall be punished by a single comprehensive crime. However, where the singleness and continuity of a criminal is not recognized in several crimes, or the method of committing a crime is not the same, each crime constitutes substantive concurrent crimes (see Supreme Court Decisions 2005Do278, May 13, 2005; 2006Do3172, Sept. 8, 2006, etc.).
(2) Determination
Comprehensively taking account of the evidence duly adopted and examined by the court below and the trial court, Defendant 1 was working as the head of the food and beverage operation headquarters in the food and beverage service division from March 2, 2007 to the head of the food and beverage operation headquarters, and continued to serve as the group meal service division in the food and beverage service division in the food and beverage business division, such as the head of the group meal service headquarters, the head of the business headquarters, the head of the food and beverage service division, and the head of the food and beverage service division. On May 16, 2011, Defendant 1 continued to serve as the group meal service division in the food and beverage division in the food and beverage business division in the food and beverage service division, and worked as the general manager of the corporation from October 16 of the same year. However, upon the regular appointment of personnel affairs, Defendant 1 is recognized as working as a general manager in the status of China as the general manager of the corporation.
Thus, as long as Defendant 1’s return to China from May 16, 201 from the position of the head of the food and beverage service division, even if he returns to China later, it cannot be readily concluded whether he will be charged with the position of the head of the food and beverage service division, whether he will be issued to another department, or whether he will be assigned to another affiliate (if Defendant 1 transferred to another department or affiliate after having come to China, it is not possible not to impose criminal liability on the crime committed by the head of the food and beverage service division after his transfer as well as criminal liability on the crime committed by the head of the food and beverage service division). Defendant 1 cannot be deemed to have maintained the criminal intent to obtain the additional money from the head of the food and beverage service division in the position of the head of the entrusted hospital in the position of the head of the food and beverage service division in China, and there is no evidence that Defendant 1 had been performing the duty of the head of the food and beverage service division in fact while working in China in China, and thus, Defendant 1 still continued to obtain the additional money after his transfer.
Therefore, Defendant 1’s crime committed before and after the Chinese work is in the relation of substantive concurrent crimes, but cannot be punished by a single comprehensive crime. If the amount acquired through △△△△△ Hospital is separately calculated, the sum total of KRW 392,842,70 from March 2007 to April 201, and KRW 221,646,620 from November 201 to November 2013, it does not constitute the element of the crime of violation of the Act on the Aggravated Punishment, etc. of Specific Economic Crimes (Fraud) with the total amount of KRW 221,646,620 from November 2013. On other premise, the lower court deemed that Defendant 1 had the continuity of the crime regardless of whether it was before and after the Chinese work, and recognized the establishment of the crime of violation of the Act on the Aggravated Punishment, etc. of Specific Economic Crimes (Fraud). Accordingly, the Defendant’s assertion pointing this out is with merit.
4. As to the violation of the National Health Insurance Act
(a) Classification of insurance benefits and insurance benefit costs;
With respect to “medical treatment provided by a patient at a medical institution and assistance devices provided by a disabled person, etc.,” the National Health Insurance Act consistently uses the term “insurance benefits” (the medical treatment provided by a medical care institution) and, with respect to “compensation paid to an institution providing insurance benefits by the National Health Insurance Corporation which evaluates the value of the insurance benefits that are real benefits and evaluates the value of the insurance benefits,” it clearly distinguishs the meaning of the two by using the term “insurance benefits cost” (the monetary compensation for the medical treatment provided by a medical care institution). However, the representative example is as follows.
(1) The Corporation shall collect all or part of the amount equivalent to the expenses for insurance benefits or insurance benefits from a person who has received insurance benefits or a medical care institution that has received insurance benefits expenses by deceit or other fraudulent means.
B. Determination
Article 115 (2) 5 of the National Health Insurance Act provides that "a person who receives or aids and abets another person to receive insurance benefits by fraud or other improper means" shall be punished.
However, as seen earlier, the National Health Insurance Act clearly distinguish “insurance benefits” from “insurance benefits” and “insurance benefits cost”. According to the National Health Insurance Act amendment draft submitted by a defense counsel, the purpose of the proposal can be known to the fact that patients, etc. receive insurance benefits by unlawful use of the health insurance card and strengthening punishment by changing them into a criminal offense from a violation of public order that is subject to the imposition of an administrative fine. In light of the above, the term “insurance benefits” under the above provision refers to physical benefits such as medical treatment provided by patients, etc. like the meaning of the term in question consistently used by the Act, and does not include the monetary meaning of the cost provided by the National Health Insurance Corporation.
Therefore, Article 115 (2) 5 of the National Health Insurance Act cannot apply to the act of falsely withdrawing the cost of insurance benefits (the cost of food insurance) instead of being illegally provided with insurance benefits (the cost of food insurance). Therefore, the lower court erred by misapprehending the legal doctrine, thereby adversely affecting the conclusion of the judgment, and the Defendants’ assertion pointing this out is with merit.
5. Whether an unreasonable sentencing is unfair
A. Defendant 3 and Defendant 7
Defendant 3 as the head of the hospital and Defendant 7 as the head of the planning office, and the head of the planning office, who pretended to have a troupbrity of the instant additional dues system under the actual control, thereby obtaining a large amount of additional dues for a long time, and Defendant 3 took part in each crime at the Incheon, Bupyeong-gu Hospital, Incheon, and Busan, and Defendant 7 took part in the crime at the Incheon, Bupyeong-gu Hospital. In particular, Defendant 7 took part in the crime, such as creating and recruiting the method of receiving the crime of defraudation of ○○○○ and the instant additional dues and directly demanding the burden of personnel expenses, such as dietitians, among the head of the planning office.
However, the crime of this case was started in the situation where the relevant authorities at the early stage of the implementation of the additional dues system clearly determine the payment requirements and did not provide specific criteria to believe them. It is difficult to view that there is a high possibility of criticism about the crime of this case since the crime of this case was committed without final judgment. When Defendant 3 and Defendant 7 conspired with the Defendants on the part of the original ○○○○ Construction Co., Ltd, in collusion with the crime of this case, it is difficult to see that the possibility of criticism or the necessity of punishment increases in proportion to the amount of fraud, even if there is no specific measure to continue the crime, since it is difficult to see that the amount of fraud or the necessity of punishment increases in proportion to the amount of fraud, since most of the already acquired amount of money was deposited and recovered considerably from damage caused by the crime of this case. Defendant 7 did not have any personal advantage as part of participating in the process of performing duties while in the hospital staff, Defendant 7 does not have any force other than fines until now, Defendant 7 is subject to criminal punishment until now, or there is no reason for punishment.
B. Defendants 5 and 8
Defendant 5 is the head of Sincheon-dong Hospital Planning Office, and Defendant 8 is involved in the crime of acquiring the additional dues of this case while he is employed as the head of Sincheon-dong Hospital Planning Team, and Defendant 8 is also involved in the crime of acquiring the additional dues of this case. In particular, Defendant 5 is subject to the aggravated punishment provision of the Act on the Aggravated Punishment, etc. of Specific Economic Crimes exceeding KRW 500 million by defraudation to the National Health Insurance Corporation. Defendant 8 is at the early stage of the crime of this case. Defendant 8 is in charge of the work of concluding the entrusted meal contract of this case while devising and consulting the structure of acquiring the additional dues of this case and moving it to the execution. On the other hand, as seen above, there is little possibility of criticism about the criminal intent of acquiring the additional dues of this case. All of them are engaged in the work for the company as a worker, and there is no profit acquired in the process of the crime of this case, the amount obtained by deception was deposited, and there is no evidence that there is no criminal punishment.
C. Defendants 4 and 6
Defendant 4 was employed as the head of the hospital in the Incheon and Gangseo-gu Hospital, and Defendant 6 took part in the crime of acquiring the additional dues of this case while being employed as the head of the planning office of the Bupyeong-gu Hospital, and the defendant 6 took part in the crime of this case. The criminal intent to obtain the additional dues of this case is a large amount of money, but as seen earlier, the criminal intent to obtain the additional dues of this case is nothing more than doscepts, and the defendant 4 is nothing more than that of this case formed by the defendant 3, who is the husband, without any specific awareness, and the defendant 6 has already been in charge of the relevant business at the hospital after the formation of the additional dues of this case was settled, and there is no profit acquired by the person in the course of this case, the amount of fraud was deposited, all of which have no criminal record, and in consideration of various sentencing conditions indicated in the records such as his age, character and conduct, environment, motive, means and consequence of the crime, the argument that the court below is unjust.
D. Defendants 9, 10, 11, 12, 13, 14, and 15
In light of the circumstances such as the fact that the amount acquired by deception cannot be deemed to be less than the amount, on the other hand, Defendant 9 succeeded to the position of the hospital in the Incheon Metropolitan City on or around September 2010. Defendant 10 was already a person who was appointed to the head of the Eunpyeong Hospital on or around June 2011 and maintained the hospital without any thoughts after the establishment of the structure of the crime of obtaining the additional money in this case. Even in the case of Defendant 11, Defendant 12, Defendant 13, Defendant 14, and Defendant 15, the former head of the planning office was bound by the structure of the crime of obtaining the additional money in this case, and thus, the criminal intent cannot be deemed to be more weak, and there is no criminal history, Defendant 9, Defendant 11, Defendant 13, Defendant 14, and Defendant 15, Defendant 10 and Defendant 12 cannot be deemed to have been subject to punishment, considering the circumstances such as punishment other than the fine, age, means of character and conduct and other circumstances, etc.
6. Conclusion
Among the grounds of appeal by Defendants 1, 2, and 16, the part of the grounds of appeal disputing the sexual nature of the violation of the National Health Insurance Act and the sexual nature of the violation of the Act on the Aggravated Punishment, etc. of Specific Economic Crimes (Fraud) against Defendants 1, 2, and 16 should be reversed. Since the remaining crimes of Defendants 1, 2, and 16 are in the relation of concurrent crimes under the former part of Article 37 of the Criminal Act, one of them should be sentenced in total. Thus, the part of the judgment of the court below against them should be reversed without complying with the legitimacy of the allegation of unfair sentencing.
As seen earlier, Defendant 3, Defendant 7, Defendant 4, and Defendant 6’s assertion of unfair sentencing is with merit. Defendant 5, Defendant 8, Defendant 9, Defendant 10, Defendant 11, Defendant 12, Defendant 13, Defendant 14, and Defendant 15’s assertion of unfair sentencing and prosecutor’s assertion of unfair sentencing are without merit.
Therefore, pursuant to Article 364(4) of the Criminal Procedure Act, all appeals filed by Defendants 5, 8, 9, 10, 11, 12, 13, 14, and 15 and prosecutor's appeals filed against them are dismissed. Pursuant to Article 364(6) of the same Act, the part of the judgment of the court below against the remaining Defendants among the judgment of the court below is reversed and the remaining Defendants are remanded through oral proceedings as follows.
Criminal facts and summary of evidence
Of the facts constituting the crime of the judgment of the court below, "The National Health Insurance Corporation 614,489,320 won" in Part 7 of Part 29 of the crime of the judgment of the court below shall be deemed to be "the National Health Insurance Corporation from March 2007 to April 201, 392,842,70 won, and 221,646,620 won from November 201 to November 201, and "the delivery of each "the delivery" in Part 4, 32, 34, and 14 of the same Act shall be deemed to be delivered", and the "the delivery of each "the delivery" in Part 7 of the judgment of the court below shall be deemed to be delivered "the delivery of each "the delivery" in Part 29, 20, 30, 30, 30, 32, 34, 17, 17, 35, and 9 of the same Act shall be deleted at the same time from the corresponding column of the judgment of the court below.
Application of Statutes
1. Article relevant to the facts constituting an offense and the selection of punishment;
A. Defendant 1, Defendant 2, Defendant 4, Defendant 6, Defendant 7, and Defendant 16: Articles 347(1) and 30 of the Criminal Act (Frauds, Defendant 1, Defendant 2, and Defendant 7) of the Criminal Act
(b) Defendant 3: Comprehensively, Article 3 (1) 2 of the Act on the Aggravated Punishment, etc. of Specific Economic Crimes, Article 347 (1) of the Criminal Act, Article 30 (Crime of Fraud of Victims of the National Health Insurance Corporation Related to Magdong Hospital), Article 347 (1) and Article 30 of the Criminal Act (Crime of Fraud against Victims of Damage and Victims of the Incheon, Bupyeong, and Donbuk Hospital)
2. Aggravation of concurrent crimes;
Article 37 (former part), Article 38 (1) 2, and Article 50 of the Criminal Code
A. Defendant 1, Defendant 2, and Defendant 16: The aggravated punishment prescribed in the crime of fraud against victims of the National Health Insurance Corporation related to △△△△ Hospital, the largest of which is the principal offender (as to Defendant 1, the part of the crime of fraud committed from March 2007 to April 201, 207, which was committed before Chinese service)
(b) Defendant 3: Aggravated increase in the penalty prescribed in the Act on the Aggravated Punishment, etc. of Specific Economic Crimes (Fraud) with the largest sentence
C. Defendant 4 and Defendant 7: The aggravated punishment stipulated in the crime of fraud against a victim of the Incheon Cheongsan Hospital related to each of the most serious crimes;
(d) Defendant 6: Aggravation of the punishment stipulated in the crime of fraud against a victim of the National Health Insurance Corporation with the largest criminal situation;
3. Discretionary mitigation (Defendant 3);
Articles 53 and 55 (1) 3 of the Criminal Act ( considered for the favorable circumstances mentioned above)
4. Attraction in a workhouse (defendants 4, 6, and 16);
Articles 70(1) and 69(2) of the Criminal Act
5. Suspension of execution (defendants 1, 2, 3, and 7);
Article 62(1) of each Criminal Act (see, e.g., Decision on the argument of unfair sentencing as to Defendant 3 and Defendant 7) (see, e.g., Decision on the argument of unfair sentencing as to the remaining two persons)
6. Order to make provisional payment (Defendants 4, 6, and 16);
Article 334(1) of the Criminal Procedure Act
Reasons for sentencing
1. Defendant 1
(a) The scope of punishment by law: Imprisonment with prison labor for not more than 15 years;
(b) Scope of recommendations based on the sentencing criteria;
[Determination of Punishment] General Fraud> Type 3 (at least 500 million won, but less than 5 billion won)
* Although multiple persons participate in the instant crime, it is an inevitable result, including the fact that there are multiple persons engaged in the entrusted meal service and the instant additional charges, and the person in charge of the instant case has been replaced in the middle, and it is difficult to view that they are closely planned in advance for the purpose of committing fraud, and that they constitute a case where they committed a crime systematically and professionally by sharing their roles in the role of each other. Thus, the sentencing guidelines for “general fraud” rather than “organization fraud” are applied (hereinafter the same shall also apply to other Defendants).
In a case where considerable damage has been recovered, where the degree of deception is weak (requirements for Mitigation), or where the crime was committed for unspecified or multiple victims or repeatedly over a considerable period of time (Aggravated factor).
[Scope of Recommendation] 4 years of imprisonment with prison labor from 1 year
* A type shall be determined on the basis of the aggregate of the amount of profit according to the method of processing the same concurrent crimes, and the lower limit of the scope of sentence shall be reduced by 1/3 according to the type 1 step increase.
(c) Determination of sentence;
Defendant 1 took part in the acquisition of large amounts of money through fraud over a long-term period of time in collusion with many executives and employees of large hospitals by working for the entrusted meal department of ○○○○○○○ Group, which is an affiliate company of a large enterprise, by forging the appearance that they actually belong to the hospital. As such, it is a large amount of money that the method of obtaining money is considerably disturbed and that the amount of fraud is about KRW 4.2 billion, and the nature of the crime and the criminal facts are not easy, from the head of the food and beverage service operation headquarters to the head of the food and beverage service business division, the fact that there was a position where the final responsibility for the crime of obtain money of this case was at least 6 years, and that the prosecution took part in attempting to destroy evidence by means of the file deletion program at the time of search and seizure of the prosecution, etc. are disadvantageous to that person.
However, according to the detailed guidelines for calculating the health insurance benefits for the patient, the government promoted the introduction of the insurance benefits system for the patient food as part of the "plan to strengthen the health insurance coverage" from 2005, but it strongly responded to the standard price for the food-based product (Evidence No. 171), No. 15, No. 16, No. 17, No. 17, and No. 18, the additional dues for the medical care institution to which the public health care institution belongs, although the public health care institution was unable to autonomously determine the patient food supply, it did not clearly understand the meaning of the additional dues that the public health care institution was able to receive as much as possible, and the public health care institution did not provide more specific guidelines for the public health care institution to which the public health care institution was allowed to receive additional dues, as the public health care institution did not provide more specific guidelines for the public health care institution to which the public health care institution was allowed to provide new additional dues and additional dues. In such circumstances, the government provided more specific guidelines for the public health care institution to which the public health care institution was allowed to pay additional dues and additional dues.
As can be seen, it is difficult for a medical institution to operate a hospital room without various additional charges. In addition, the government failed to carefully examine the consistency and predictability of the remaining system that was urgent for the introduction of the insurance benefits system to the hospital food for inpatients, and thus failed to clearly set the payment requirements. As a result, measures to supplement these problems are not taken at all even after several years, it is difficult to lower the level of suspicions of various additional charges to supplement the shortage of hospital food revenues and to conveniently express the purpose of the system only in the direction favorable to them. As a result, it is difficult to use the law such as the crime of this case. As seen earlier, it is difficult for them to use the law as a means of crime of this case. As such, it is hard to view that the crime of this case to have been carried out at least before and after the enforcement of the sentence of this case, it is hard to view that the crime of this case was committed with the intention of deceiving the victim to have been carried out at least before and after the enforcement of the sentence of this case. As such, it is difficult to see that the crime of this case’s illegal motive or crime of fraud by the defendant 1.
2. Defendant 2
(a) The scope of punishment by law: Imprisonment with prison labor for not more than 15 years;
(b) Scope of recommendations based on the sentencing criteria;
[Determination of Punishment] General Fraud> Type 3 (at least 500 million won, but less than 5 billion won)
In a case where considerable damage has been recovered, where the degree of deception is weak (requirements for Mitigation), or where the crime was committed for unspecified or multiple victims or repeatedly over a considerable period of time (Aggravated factor).
[Scope of Recommendation] 4 years of imprisonment with prison labor from 1 year
* A type shall be determined on the basis of the aggregate of the amount of profit according to the method of processing the same concurrent crimes, and the lower limit of the scope of sentence shall be reduced by 1/3 according to the type 1 step increase.
(c) Determination of sentence;
Defendant 2, a person who served as the head of ○○○○○○ Hospital Operation Team from August 1, 2009, was a large amount of money obtained by acquiring a total of 3.6 billion won by taking part in the crime of acquiring the additional dues of this case, and the period of the crime is about four years, the destruction of evidence is involved in the City/Do, and the crime is also relatively weak; on the other hand, there is no reason to strengthen punishment in proportion to the amount of the crime of this case; there is no personal benefit acquired as a person in charge of the crime of this case; the establishment of policies and the design and operation of the system provide the person for the crime of this case; the fact that most of the additional dues of this case was repaid by the entrusted hospital; there is no history of criminal punishment; the fact that the period of the crime of this case was under detention for about 11 months; and other favorable circumstances, such as the circumstances, age, character and behavior of the crime of this case; and the motive of execution before and after the execution of the crime of this case.
3. Defendant 3
(a) The scope of punishment by law: Imprisonment with prison labor for a period of one year and six months and 22 months; and
(b) Scope of recommendations based on the sentencing criteria;
[Determination of Punishment] General Fraud> Type 3 (at least 500 million won, but less than 5 billion won)
In a case where considerable damage has been recovered, where the degree of deception is weak (requirements for Mitigation), or where the crime was committed for unspecified or multiple victims or repeatedly over a considerable period of time (Aggravated factor).
[Scope of Recommendation] From one year and six months of imprisonment, 4 years of imprisonment (Mitigation)
(c) Determination of sentence;
In determining the above assertion on unreasonable sentencing, the circumstances examined in determining the punishment as per the Disposition and suspending the execution thereof shall be comprehensively taken into account.
4. Defendant 7
(a) The scope of punishment by law: Imprisonment with prison labor for not more than 15 years;
(b) Scope of recommendations based on the sentencing criteria;
[Determination of Punishment] General Fraud> Type 3 (at least 500 million won, but less than 5 billion won)
In a case where considerable damage has been recovered, where the degree of deception is weak (requirements for Mitigation), or where the crime was committed for unspecified or multiple victims or repeatedly over a considerable period of time (Aggravated factor).
[Scope of Recommendation] 4 years of imprisonment with prison labor from 1 year
* A type shall be determined on the basis of the aggregate of the amount of profit according to the method of processing the same concurrent crimes, and the lower limit of the scope of sentence shall be reduced by 1/3 according to the type 1 step increase.
(c) Determination of sentence;
In determining the above assertion on unreasonable sentencing, the circumstances examined in determining the punishment as per the Disposition and suspending the execution thereof shall be comprehensively taken into account.
5. Defendants 4 and 6
(a) Scope of applicable sentences by law: Not more than 30 million won of a fine (to apply the sentencing criteria on the selection of a fine);
(b) Determination of sentence;
In determining the above assertion of unfair sentencing, the circumstances examined in determining the above assertion of unfair sentencing shall be determined as per the Disposition.
6. Defendant 16
(a) Scope of applicable sentences by law: Not more than 30 million won of a fine (to apply the sentencing criteria on the selection of a fine);
(b) Determination of sentence;
From July 16, 2010 to September 2, 2013, Defendant 16 took part in the crime of acquiring the instant additional dues by managing △△△ Hospital, △△ Hospital, △△ Hospital, and △△△△△ Hospital as the director of the division of the ○○○○○ Hospital Operation Team from July 16, 2010 to September 2, 2013. Although the amount of money obtained by deception is not so much, the degree of participation in the crime is relatively minor because the class is low compared to the Defendants in other ○○○○○○○○○○○○ Group, but there is no record of criminal punishment other than fines, and all the sentencing conditions specified in the pleadings such as his age, character and conduct, motive, means and consequence of the crime, etc.
Parts of innocence
1. Violation of the Act on the Aggravated Punishment, etc. of Specific Economic Crimes (Fraud) against Defendant 1 among the facts charged in this case
A. Summary of the facts charged
As seen earlier, Defendant 1, in collusion with the head of △△△△ Hospital, etc., did not actually belong to the hospital, and thus, did not meet the requirements for the supply and demand of the instant additional dues, Defendant 1 filed a claim for the instant additional dues that would lead to the actual direction and supervision of the hospital by directly employing him and bearing expenses, such as personnel expenses, even though the hospital failed to meet the requirements for the supply and demand of the instant additional dues. As such, Defendant 1 received a total of KRW 614,489,320 from the
B. Determination
As seen earlier, Defendant 1 ceases to have the continuity of the crime by deception with the Chinese service, and there is no uniformity or continuity of the crime between the crimes before and after the commission of the crime. Accordingly, if the amount obtained by deception before and after the commission of the Chinese service is separately calculated, all of the facts charged do not constitute the constituent elements of the crime of violation of the Act on the Aggravated Punishment, etc. of Specific Economic Crimes (Fraud), which is less than KRW 500 million. Therefore, this part of the facts charged is a case where there is no proof of the facts charged, and thus, should be acquitted pursuant to the latter part of Article 325 of the Criminal Procedure Act, but
2. Of the facts charged in this case, the violation of the National Health Insurance Act against Defendants 1, 2, and 16
A. Summary of the facts charged
Defendant 1, Defendant 2, and Defendant 16 received the insurance benefits of KRW 53,961,040 in total through △△△ Hospital from June 2013 to August 201 of the same year through 53,9290 (Defendant 16 was recruited and participated in only 53,929,310 won that occurred from June 201 to August 201) in collusion with the executive officers and employees of △△△△△△△ Hospital, △△△ Hospital, and △△△△△△△△ Hospital, by pretending to belong to the hospital as nutritions, etc., and received the insurance benefits of KRW 53,961,040 in total through △△△△ Hospital from June 2013 to August 201 of the same year.
B. Determination
Article 115(2)5 of the National Health Insurance Act provides that “A person who receives or aids and abets another person to receive insurance benefits by fraud or other improper means,” but as seen earlier, Defendants 1, 2, and 16’s act merely received insurance benefits by withdrawing “expenses incurred in relation to insurance benefits,” and thus does not constitute “insurance benefits” itself.
Therefore, this part of the facts charged should be pronounced not guilty in accordance with the former part or the latter part of Article 325 of the Criminal Procedure Act because it constitutes a case where the facts charged do not constitute a crime or there is no proof of a crime. However, as long as the court found the guilty of a crime in a commercial concurrent relationship,
[Attachment]
Judges Jindo (Presiding Judge)