[1] The meaning of "medical records" under Articles 11(3) and 38(3) of the Guarantee of Automobile Accident Compensation Act and Article 21(1) of the Medical Service Act

[2] In a case where a medical fee covered by an automobile insurance was claimed according to the medical records prepared by a doctor, but there is no stipulation that the prescription recorded in the records of other medical records such as nursing has been enforced, whether the case constitutes “a claim for medical fee covered by automobile accident insurance differently from the medical records recorded in the medical records” under Article 38(3) of the Guarantee of Automobile Accident Compensation Act

[1] The term "medical record" under Articles 11(3) and 38(3) of the Guarantee of Automobile Accident Compensation Act and Article 21(1) of the Medical Service Act means, regardless of its name, a medical doctor, dentist, or oriental medical doctor in charge of the patient's medical treatment and his/her opinion on the patient's medical treatment. It is distinguished from the midwifery record, the nursing record, the physical treatment register, the radiation photographing register, etc. prepared by a person other than a medical doctor, dentist, or oriental medical doctor.

[2] If a person files a claim for medical fee covered by automobile accident insurance in accordance with the medical record prepared by a doctor, even if there is no entry that the prescription, etc. was enforced, it shall not be deemed that the case constitutes an "medical fee covered by automobile accident insurance differently from the medical record entered in the medical record register under Article 38 (3) of the Guarantee of Automobile Accident Compensation Act, even though there was no entry that the prescription was enforced

[1] Articles 11(3) and 38(3) of the Guarantee of Automobile Accident Compensation Act, Article 21(1) of the Medical Service Act / [2] Articles 11(3) and 38(3) of the Guarantee of Automobile Accident Compensation Act

Defendant

Prosecutor

Attorney Jeong Jin-jin et al.

Busan District Court Decision 2005No2761 Delivered on December 29, 2005

The appeal is dismissed.

We examine the grounds of appeal.

Article 11(3) of the Guarantee of Automobile Accident Compensation Act provides that “When a medical institution claims medical fees covered by automobile accident insurance from an insurer, etc. pursuant to the provisions of paragraph (2) of this Article, the medical institution shall file a claim in accordance with the medical records of the medical examination and treatment provided for in Article 21 of the Medical Service Act.” Article 38(3) of the same Act provides that “A medical institution which, in violation of the provisions of Article 11(3), requests automobile accident insurance differently from the medical records of the medical examination and treatment, or prepares false medical records for the purpose of claiming it shall be punished by a fine not exceeding 50 million won.” Article 21(1) of the Medical Service Act provides that “A medical person shall keep the medical records, assistance in child delivery records, nursing records, and other records concerning the medical treatment (hereinafter “medical records, etc.”) and shall record in detail the matters concerning the medical treatment and opinions thereof, regardless of its name, if a doctor, dentist, or oriental medical doctor in charge of the patient’s medical examination and treatment record prepared in accordance with the record, etc.

Examining the reasoning of the judgment below in light of the records in light of the above legal principles, since the defendant who is a doctor of the court below claimed medical fee insurance in the same manner as the medical records he prepared, the defendant's act does not constitute "medical fee for automobile accident insurance differently from the medical records entered in the medical record register" as provided in Article 38 (3) of the Guarantee of Automobile Accident Compensation Act, and it is acceptable to find the defendant not guilty on the ground that there is no proof as to the facts charged in this case, and there is no error of law such as misunderstanding of facts against the rules of evidence or misunderstanding of legal principles as

Therefore, the appeal is dismissed. It is so decided as per Disposition by the assent of all participating Justices on the bench.

Justices Ahn Dai-hee (Presiding Justice)