National Health Insurance Corporation (the chief of the National Health Insurance Corporation and one other)

Defendant (Attorney Full Il-il, Counsel for defendant-appellant)

January 15, 2013

1. The plaintiff's claim is dismissed.

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

The defendant shall pay to the plaintiff 90,887,180 won with 5% interest per annum from February 2, 2012 to the service date of a copy of the complaint of this case, and 20% interest per annum from the next day to the day of complete payment.

1. The plaintiff's assertion

On November 8, 2002, the Nonparty, an employee of the Defendant Company, suffered from occupational accidents at the workplace of the Defendant Company, and received medical care from the Korea Workers’ Compensation & Welfare Service for industrial accident compensation insurance on December 19, 2007, and the period for approval of medical care was terminated. Thereafter, the Plaintiff paid the Nonparty’s charge to the hospital from among the medical treatment expenses incurred from occupational accidents, which led to the Nonparty’s payment to the hospital. Accordingly, the Defendant obtained the Nonparty’s benefit that would be exempted from the liability for medical care compensation under the Labor Standards Act without any legal cause, and thus, the Defendant is obligated to return the said

2. Determination:

Article 78(1) of the Labor Standards Act provides, “When an employee suffers from an occupational accident or disease, an employer shall provide necessary medical care at his/her expense or bear necessary medical care expenses.” Article 87 of the same Act provides, “If a person entitled to receive compensation receives money or goods equivalent to accident compensation under the Civil Act or other Acts and subordinate statutes for the same reason, the employer shall be exempted from liability for compensation within the limit of the value thereof.” Meanwhile, Article 80(1) of the Industrial Accident Compensation Insurance Act provides, “Where a beneficiary has received or is entitled to receive insurance benefits under this Act, the insured shall be exempted from liability for accident compensation under the Labor Standards Act for the same reason.” The purport of the provision is that the Industrial Accident Compensation Insurance Act provides, “The insured shall be exempted from liability for accident compensation under the Labor Standards Act.” This is that it is not favorable for an employee to have the employee first claim industrial accident compensation insurance benefits, and that an employer shall have the employee take part in the industrial accident compensation insurance, even if he/she has paid the insurance benefits later, it shall be deemed that the employer should have paid the insurance benefits after 108.

There is no dispute over the fact that the defendant is an industrial accident compensation insurance policyholder.

In light of the above legal principles and facts. If hospital treatment for the non-party after December 20, 2007, as alleged by the plaintiff, was caused by occupational accident, and thus, could have received insurance benefits under the Industrial Accident Compensation Insurance Act due to the application for additional medical care, etc., the non-party’s employer and the insured under the Industrial Accident Compensation Insurance Act are exempted from the liability for accident compensation under the Labor Standards Act pursuant to Article 80(1) of the Industrial Accident Compensation Insurance Act. Meanwhile, if hospital treatment for the non-party after December 20, 2007 is not caused by occupational accident, and it is not subject to additional medical care, the defendant is not liable for medical care compensation under the Labor Standards Act. Therefore, regardless of whether the above treatment for the non-party was caused by occupational accident, the defendant cannot be deemed to be exempted from the liability for accident compensation for the non-party due to the plaintiff’s payment of insurance benefits. Thus, there is no causation between the expenditure of the above insurance benefits and the defendant’s exemption from liability for accident compensation, and there is no legal ground for the defendant’s exemption from liability.

Therefore, the plaintiff's above assertion based on the premise that the defendant company exempted the defendant company from liability for medical care compensation under Article 78 (1) of the Labor Standards Act due to the above payment of insurance benefits, and obtained benefits without any legal ground cannot be accepted.

3. Conclusion

Therefore, the plaintiff's claim of this case is dismissed as there is no reason.

Judges Choi Chang-chul