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The plaintiff's appeal is dismissed.
2. The costs of appeal shall be borne by the Plaintiff.
Purport of claim and appeal
The judgment of the first instance.
Reasons
1. Basic facts
A. The Plaintiff entered into an insurance contract (C) with the Defendant to compensate for losses, etc. suffered by being hospitalized due to a disease, etc. that occurred during the insurance period (from November 11, 2013 to November 11, 2050).
The term of hospitalization begins from February 6, 2014 to March 5, 2014, to March 7, 2014, to March 26, 2014; or from March 26, 2014 to April 17, 2014; or from May 11, 2014 to May 13, 2014; or from May 22, 2014 to May 22, 2014 to June 27, 2014 to June 27, 2014 to June 27, 2014 to June 27, 2014 to April 17, 2014 to June 4, 2014 to June 27, 2014.
The Defendant received hospitalized treatment on the ground of the “mark scarcity” from the E Hospital located in Si-si (hereinafter referred to as the “E Hospital”) as follows, and received KRW 38,418,692 (hereinafter referred to as the “instant insurance proceeds”) totaling KRW 38,418,692 (hereinafter referred to as “instant insurance proceeds”).
C. F, the operator of the E Hospital, in collusion with G G (the deceased on December 12, 2016), etc., the president of the E Hospital. The fact was that H, a patient, did not prescribe and receive treatment for high-frequency therapy and physical therapy, and there was no prescription and treatment as much as the number of times indicated in the medical records, etc.; however, even though there was no fact that the E hospital received treatment in the amount of medical expenses indicated in the medical expenses receipt, the E hospital provided H with a receipt of medical expenses that received treatment and received treatment in the E hospital, and provided H with a receipt of medical expenses to claim for the amount of the lost insurance proceeds from the affected insurance company and received them. From October 18, 2012 to July 19, 2016, H was indicted with imprisonment with prison labor and other injury insurance companies including the Plaintiff and transferred the money in the name of patients under the name of the damaged insurance company and charged with fraud under the Medical Service Act for 2018 May 21, 2018.