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1. The plaintiff's claim is dismissed.
2. The costs of lawsuit shall be borne by the Plaintiff.
Reasons
1. Details of the disposition;
A. On January 5, 2017, the Plaintiff, a beneficiary of medical benefits, filed a lawsuit for damages (Seoul Southern District Court 2017Dadan241127) against B, an insurance company of the injured vehicle, due to a traffic accident that occurred in January 5, 2017, filed a lawsuit for damages (Seoul Southern District Court 201,69,761 won and delay damages) against B, which is the insurance company of the injured vehicle. The judgment was rendered on July 25, 2018.
B. B around August 2018, the Plaintiff paid KRW 229,360,740 to the Plaintiff as the amount of damages and damages for delay under the above judgment. Of them, the future treatment costs are KRW 31,62,725.
C. On September 4, 2018, the Defendant notified that medical benefits for the Plaintiff are restricted pursuant to Article 4 of the Medical Care Assistance Act (hereinafter “instant disposition”).
[Ground of recognition] Facts without dispute, entry of Gap evidence 2, 9, and 10, the purport of the whole pleadings
2. Whether the disposition is lawful;
A. The Plaintiff’s assertion that the Plaintiff asserted medical benefits should be provided to the Plaintiff for KRW 1,301,90,02 (=2,745,150 - 1,443,90 - 1,443,248 won out of the amount of damages paid by the Plaintiff for 73 days from June 21, 2018 to August 31, 2018, computed by converting KRW 6,679,920 from the average monthly amount of KRW 2,745,150, a monthly amount of damages paid by B Co., Ltd. (i.e., KRW 1,43,248).
Article 4 (Exclusion from Application) (1) If a beneficiary becomes eligible for benefits or compensation under other Acts and subordinate statutes due to a disease, injury, or accident incurred in the course of performing his/her duties or on official duty, no medical benefits under this Act shall be provided.
(2) Where an eligible recipient receives benefits or expenses equivalent to medical benefits from the State, a local government, etc. pursuant to other statutes, he/she shall not provide medical benefits under this Act to the extent thereof.
B. Relevant statutes
C. Article 4(2) of the Medical Care Assistance Act provides medical benefits to the extent that a beneficiary is entitled to medical benefits under any other statute.