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(영문) 부산지방법원 2013.08.22 2013노914
사기
Text

The prosecutor's appeal is dismissed.

Reasons

1. The gist of the grounds of appeal is whether the issue of this case is whether the above patient was hospitalized at the Defendant’s operating hospital and the act of preparing and delivering a written confirmation of entrance and discharge in collusion with the above patient can be deemed to have obtained insurance money by fraud as stated in the written confirmation of entrance and discharge written by the Defendant, which was prepared and delivered to the patient. In light of the following, most of the patients of this case were not hospitalized at the actual Defendant’s operating hospital by taking into account the following factors: (a) most of the patients of this case were forced to do so by surgery from the Defendant; and (b) the Defendant was actively participating in the fraud of the insurance money by preparing and delivering a written confirmation of entry and discharge for 2-day one-day gambling; (c) however, the judgment of the court below is erroneous in the misapprehension of facts, which affected the conclusion of the judgment.

2. Determination

A. The summary of the facts charged is that the Defendant directly participates in the overall operation of the hospital, such as diagnosis and treatment of patients, surgery, decision on entrance and discharge, confirmation of entrance and discharge, and issuance of medical certificates, or orders and supervision to nurses, etc., with the head of the 4th floor of the Busan Bridge, Busan, and a person in charge of the operation of the hospital.

The above hospital operated by the defendant is a hospital specializing in the treatment and surgery of non-pocks, and is using the rash marcule (EVLT) and the blood culmatization (EVLT).

The operation through the above method is non-benefit items that are not included in the insurance benefits of the National Health Insurance Corporation. The patient must personally subscribe to the loss insurance of the private insurance company and be hospitalized after the operation, but the patient can receive insurance money from 30% to 10% of the medical expenses to be borne by the patient according to the terms and conditions of the contract for the medical expenses of the private insurance company, such as Samsung Fire and Marine Insurance Co., Ltd.

However, there is a problem.

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