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(영문) 대전고등법원 2021.01.28 2020누10898
요양급여부지급처분취소
Text

1. Revocation of the first instance judgment.

2. The Defendant’s non-approval disposition for medical care rendered to the Plaintiff on March 7, 2019 shall be revoked.

3.

Reasons

1. The reasons for this part of the disposition are as stated in the corresponding part of the judgment of the court of first instance, except for the modification of some contents as follows. Thus, this part of the reasoning is cited in accordance with Article 8(2) of the Administrative Litigation Act and the main sentence of Article 420 of the Civil Procedure Act.

On the first head of the first place of the second parallel, “the plaintiff has been employed as urban bus driver as a male male on June 1954.”

“” shall be added.

Part 2 The "3-11 times" of the 8th election shall be raised to "5-10 times".

The second 10 to 11 conduct "for the reasons that it occurred" shall be as follows:

“The instant accident occurred” has an inevitable circumstance to the extent that the Plaintiff was able to commit the central line.

It is difficult to see that the Plaintiff’s violation of the Road Traffic Act is the main cause of the accident, and it does not constitute a disaster during the work under Article 37 of the Industrial Accident Compensation Insurance Act.

2. Whether the instant disposition is lawful

A. On the following grounds, the purport of the Plaintiff’s assertion is that the instant accident constitutes occupational accidents, and thus, the instant disposition that did not recognize occupational accidents on a different premise is unlawful.

1) The cause of the instant accident is driving at a graduate in the Plaintiff’s ordinary work process, which does not constitute an intentional act or a criminal act committed by a “worker on the grounds not deemed an occupational accident” under Article 37(2) of the Industrial Accident Compensation Insurance Act.

On the other hand, the central scambling act is the result of the operation of the above scambling, and the central scambling act itself does not constitute the main cause of the accident in this case.

2) The Plaintiff’s five days worked at around 05:00 a.m. and the five days after a day worked at around 05:00 a.m. and worked at around 2 p.m.. The Plaintiff’s stroke is due to the rhythm of body due to the above special work type. The Plaintiff’s stroke-out operation was generated due to the rhythm of body due to the above special work type.

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