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(영문) 서울중앙지방법원 2016.12.13 2014가합565267
손해배상(기)
Text

1. The Defendants jointly share KRW 203,698,540 with respect to the Plaintiff, and the period from September 26, 2014 to September 30, 2015.

Reasons

1. Determination as to the cause of claim

A. 1) The Plaintiff is a juristic person established pursuant to the Industrial Accident Compensation Insurance Act and entrusted by the Minister of Employment and Labor, and engaged in the industrial accident compensation insurance business. 2) On May 16, 2003, the Plaintiff designated Dental members (hereinafter “instant hospital”) located in Gangdong-gu Seoul Metropolitan Government as a medical institution in charge of medical care for workers suffering from occupational accidents (hereinafter “industrial accident insurance-related medical institution”). At the request of the instant hospital’s medical care benefit costs, the Plaintiff paid the instant hospital totaling KRW 288,353,610 as medical care benefit costs.

3) However, the instant hospital employs Defendant A, rather than a medical person, who is a doctor of Defendant B, and establishes a loan under the name of Defendant A. Defendant B had Defendant A treat an employee subject to industrial accident insurance, and then claimed medical care benefit costs against the Plaintiff. The instant hospital claimed for medical care benefit costs against the Plaintiff after having the Defendant A treated the employee subject to industrial accident insurance. The instant hospital did not have any dispute, and the Plaintiff’s evidence Nos. 1 through

written evidence Nos. 1 and 2 and the purport of the whole pleadings

B. If Defendant B, a non-medical person, established the instant hospital, the instant hospital constitutes a medical institution established in violation of Article 33(2) of the Medical Service Act, and thus, the instant hospital does not constitute an industrial accident insurance-related medical institution that can claim medical care benefit costs based on Article 43(1) of the Industrial Accident Compensation Insurance Act, and medical care benefit costs paid upon the request of the instant hospital cannot be included in the medical care benefit amount under the Industrial Accident Compensation Insurance

Therefore, it would result in the loss of allowing the plaintiff to pay the medical care benefit cost to the medical treatment act not subject to the medical care benefit, and it would result in the plaintiff to pay the medical care benefit cost to the medical treatment act not subject to the medical care benefit.

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