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(영문) 수원지방법원 2017.10.13 2017노4041
소비자생활협동조합법위반등
Text

The judgment below

The part against the defendant shall be reversed.

Defendant shall be punished by imprisonment for a term of one year and nine months.

In this case.

Reasons

1. The summary of the grounds for appeal (unfair sentencing) by the lower court (two years of imprisonment) is too unreasonable.

2. An ex officio determination 1) Of the fraud crimes in the holding of the court below, the part that the defendant, among the fraud crimes in the holding of the court below, by deceiving the victim insurance companies to receive the cost of automobile medical treatment and by receiving the cost of automobile medical treatment from the victim insurance companies, shall be considered as the part that the defendant acquired by deception.

Article 42(1)1 of the National Health Insurance Act limits medical institutions, one of the health care institutions eligible for the provision of health care benefits, to “medical institutions established under the Medical Service Act”. Thus, if a non-medical institution established by a non-medical person claims reimbursement of health care benefits to the National Health Insurance Corporation, as if it were legally established under the Medical Service Act, and received reimbursement of health care benefits (see, e.g., Supreme Court Decision 2014Do11843, Jul. 9, 2015). Meanwhile, Article 2 Subparag. 7 of the Motor Vehicle Compensation Security Act provides that “The number of automobile insurance medical care fees” refers to the amount of expenses incurred by a person who suffered an accident due to the operation of a motor vehicle receiving medical care in the “medical institution under the Medical Service Act” and falls under any of the following cases:

“........”

However, the reason why the National Health Insurance Act limits a medical institution, one of the medical care institutions that can provide medical care benefits, to the "medical institution established under the Medical Service Act" is to further announce the legislative purpose of the Medical Service Act in order to prevent risks to national health in advance, which may arise in the event that a medical institution is established and a medical institution is established for the purpose of establishing a sound medical order and profit-making by limiting it to medical personnel with expertise in the qualification to establish a medical institution or to a public person

On the other hand, the Guarantee of Automobile Compensation is to guarantee the compensation of damages in the event of automobile accident.

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