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1. The plaintiff's appeal is dismissed.
2. The costs of appeal shall be borne by the Plaintiff.
Purport of claim and appeal
The first instance court.
Reasons
1. The reasoning for the court’s explanation concerning this case is as stated in the reasoning of the judgment of the first instance except for the following judgments. Thus, it is acceptable to accept this as it is in accordance with the main sentence of Article 420 of the Civil Procedure Act.
2. Additional determination
A. The Plaintiff’s assertion 1) Pursuant to Article 49 of the National Health Insurance Act, the insured or his/her dependent has the right to directly claim and receive medical care expenses equivalent to medical care benefits in addition to the right to claim for benefits in kind. If the Plaintiff received medical care at his/her own expense, as in the instant case, inasmuch as the Plaintiff was unable to claim medical care benefits through a medical care institution due to “emergency or other inevitable reasons” as prescribed by the National Health Insurance Act, and thus, the Plaintiff is entitled to directly claim medical care expenses to the Defendant. (2) Article 23(1) and (2) of the Enforcement Rule of the National Health Insurance Act provides that the insured or his/her dependent’s claim for medical care expenses is too narrow to the extent that the insured or his/her dependent claims for medical care expenses, thereby contributing to the improvement of public health and the promotion of social security.
B. The provisions pertaining to the Plaintiff’s assertion are as follows.
(1) Where a policyholder or his/her dependent has received medical care for a disease, injury, childbirth, etc. or given birth at a place other than a medical care institution in an institution prescribed by Ordinance of the Ministry of Health and Welfare (including a medical care institution under the period of suspension of business under Article 98 (1)) due to an emergency prescribed by Ordinance of the Ministry of Health and Welfare or due to other inevitable reasons, the NHIS shall determine an amount equivalent to the