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The defendant shall be innocent.
Reasons
1. The summary of the facts charged of this case was around December 2, 1997, the Defendant subscribed to 12 insurance policies, including the Life-long and General Health Insurance for Life-Free Distribution. The above insurance is an insurance policy that guarantees that daily allowances for hospitalization are paid when hospitalized or hospitalized at the time of injury or disease, or that long-term hospitalization is paid.
As seen above, Defendant 1: (a) filed a multiple insurance policy; (b) filed a false pain, claiming for a false pain, which does not require hospital treatment; or (c) received a daily allowance for hospitalization from the victim insurance companies by increasing the period of hospitalization.
The Defendant, from around December 15, 2007 to January 4, 2008, did not need to conduct long-term hospitalized treatment with D fixed-type D located in Nam-gu Incheon Metropolitan City C. However, the Defendant hospitalized the victim Samsung Fire, etc. under the name of disease, such as “Gyeong-gu salt,” and claimed insurance proceeds from the victim’s insurance company from January 8, 2008 to January 16, 2008, and received KRW 5,595,998 in total from the victim’s insurance company from January 8, 2008 to January 16, 2008.
(Attachment No. 1) The Defendant, including that, from that time until May 13, 2015, received insurance proceeds of KRW 125,314,237 in total by deceiving the victim insurance companies over 30 times in the same manner as indicated in the list of crimes in the attached Table from that time.
2. Determination:
A. The response of the Health Insurance Review Evaluation Institute (hereinafter “Health Insurance Review Evaluation Institute”) to deliberate on the propriety of hospitalization is that most of seven days (7 days (or 14 days) during each of the Defendant’s disease period in light of the details of medical treatment, patient status, etc. based on the record of medical examination and treatment is appropriate.
However, even the same illness can be easily affected by the patient's pain or inconvenience, and the number of days of hospitalization can also be affected by the seriousness of symptoms, discretion of doctors, hospital's policies, trust relationship between the patient and the hospital as well as the individual characteristics of the patient.