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(영문) 서울남부지방법원 2016.11.11 2014가합113211
손해배상(기)
Text

1. The plaintiff's claim is dismissed.

2. The costs of lawsuit shall be borne by the Plaintiff.

Reasons

1. 231 persons, including B, etc. who concluded the Plaintiff’s assertion with the Plaintiff and the Defendant’s insurance contract, received 437,169,844 won in total from the Plaintiff, following the Defendant’s “C Hospital” that was administered by the Defendant and received medical treatment, such as running water treatment, etc.

The Defendant asked 231 persons, B, etc., to whether to subscribe to medical room insurance, and the limit thereof, and then, recommended them to receive insurance benefits in the event of advance payment by taking advantage of the medication, beauty surgery, and nutrition injection as a package, and made false medical records and receipts for medical expenses to the 231 persons, including B, etc., even in the case of cosmetic treatment, such as bad chicking, skin clicking, bruthing clinic, bruth clinic, etc., or in the case of no need to receive outpatient treatment, and prepared false medical records and receipts for medical expenses as if they were receiving injury or disease treatment.

Due to the defendant's above illegal acts, the plaintiff suffered damages that the plaintiff paid total of KRW 437,169,844 to 231 persons, including B, etc.

Therefore, the defendant is liable to compensate the plaintiff for damages amounting to 437,169,844.

2. The excessive treatment of medical expense items of the judgment medical institution frequently leads to the aggravation of the damage ratio of the lost medical expense insurance.

Even if this is generalized, it cannot be inferred that the defendant committed such an act, and the fact that the defendant committed an illegal act such as excessive treatment and issuance of false medical receipts must be proved by the plaintiff.

However, it is not sufficient to recognize that the Defendant provided unnecessary treatment to the Plaintiff’s insured workers or prepared false medical records, and there is no other evidence to acknowledge this. Thus, the Plaintiff’s claim is without merit without need to further examine.

3. The plaintiff's claim for conclusion is dismissed for reasons.

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