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(영문) 전주지방법원 2014.11.05 2014구합66
요양급여비 환수결정취소
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. The Plaintiff is establishing and operating the B Hospital located in the Jeonsi-gu Seoul Special Metropolitan City (hereinafter “instant hospital”).

B. On October 2007, the Plaintiff entered into a contract with C (hereinafter “C”) to supply food materials to the cafeteria of the instant hospital (hereinafter “the instant cafeteria”).

C. On October 15, 2012, the Gyeonggi Local Police Agency notified the Defendant of the investigation results on the criminal facts that the Plaintiff, by deceiving the Defendant, acquired the Defendant an in-patient surcharges of KRW 156,561,00 from the Defendant.

As the premises of this case is substantially entrusted by C, it is not necessary to request the direct calculation (620 won), dietitians (550 won), and the cooking surcharge (500 won) from among the costs of health care benefit paid by the Defendant.

Nevertheless, in order to receive additional charges on food direct operation among the health care benefit for in-patient patients, the Plaintiff shall establish a dietitian and a cook in the instant case under the jurisdiction of the instant hospital, and, in substance, entrusted the instant cafeteria in C with the operation of the instant cafeteria, such as the aforementioned dietitians, cook's pay, four major premiums, retirement allowances, etc., but he reported the completion to the Defendant as if he operated the cafeteria directly, and the Defendant Review and Assessment Service claimed additional charges on the cafeteria and received the payment.

After filing a false report to the Defendant that the Plaintiff directly operated the instant cafeteria, the Plaintiff filed a claim for the additional charge from the Defendant’s health care benefit for in-patient to the Defendant Review and Assessment Service on July 2008, and received the additional charge 480,960 won from the Defendant on July 2008.

The Plaintiff deceptioned the Defendant by the foregoing method, and that deceivings the Defendant from July 2008 to February 2012, 200, the Plaintiff acquired KRW 156,134,980 from the Defendant to the passbook in the name of the Plaintiff and acquired the money.

The defendant is above C.

result of the investigation described in paragraph (1).

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