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(영문) 서울중앙지방법원 2014.10.31 2014가단5194731
부당이득금
Text

1. The Defendant’s KRW 52,755,00 for the Plaintiff and 5% per annum from October 30, 2013 to July 25, 2014.

Reasons

1. Facts of recognition;

A. A, a company, who worked on August 15, 2009, completed the conference of the National Bank of Korea on August 15, 2009, went at the home and went away from the awareness of brain fluencing symptoms, and was treated in a medical college Sym Hospital, etc. from the same day until September 24, 2013.

B. On September 24, 2013, the Defendant rendered a decision of additional medical care for the application for approval of an industrial accident of A.

C. From November 25, 2009 to October 29, 2013, the Plaintiff paid KRW 263,043,360 to the above hospital, etc., excluding KRW 61,332,750 of the Plaintiff’s charges, excluding KRW 61,710,610 of the Plaintiff’s charges, and KRW 5,463,080 of the Plaintiff’s charges.

The Defendant paid KRW 154,072,690, which occurred within three years from the medical treatment date of the Industrial Accident Compensation Insurance Act (wholly amended by Act No. 9988, Jan. 27, 2010; hereinafter “Industrial Accident Compensation Insurance Act”) and the date of treatment A, and refused payment of KRW 52,75,000, excluding the remainder KRW 346,000, which is the amount of reduction of medical expenses for personal illness, out of KRW 53,101,00.

[Ground of recognition] Facts without dispute, entry of Gap 1-4 evidence, purport of the whole pleadings

2. The assertion and judgment

A. If an employee affected by occupational accidents received benefits (insurance benefits) equivalent to medical care benefits as stipulated in Article 40 of the Industrial Accident Compensation Insurance Act from the National Health Insurance Corporation, the insurer under the National Health Insurance Act, the employee cannot exercise the right to claim medical care benefits due to occupational accidents against the Korea Workers' Compensation and Welfare Service, which is the insurer under the Industrial Accident Compensation Insurance Act. As such, the Korea Workers' Compensation and Welfare Service is obligated to return benefits accrued from being exempted from the obligation to provide medical care benefits to the employees of the National Health Insurance Corporation (see Article 53(1)4 of the National Health Insurance Act, Supreme Court Decision 2004Da12660, Apr. 28, 2005). According to the above facts, barring any special circumstance, the Defendant is 52,75,0

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