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TITLE Supreme Court Decision 2019Da279962 Decided December 10, 2020【Payment of Motor Vehicle Insurance Medical Fees】 [full Text]
Summary
[1] Whether the provision of the notice by the Health Insurance Review and Assessment Service, which stipulates that “in the case of the referral of a hospitalized patient to another medical facility, the referring facility shall make a claim for motor vehicle insurance medical fees, and the medical facility that provides medical care shall not make a claim,” is binding upon medical facilities that provide medical care or insurance companies, etc. (negative)
[2] In a case where the Health Insurance Review and Assessment Service, which unilaterally created an internal rule for the expediency and convenience of the administration of business, refuses to conduct a substantive review of claims filed by medical facilities that provided medical care for motor vehicle insurance medical fees on the grounds of the said internal rule, yet insurance companies, etc. do not take measures, such as urging the Health Insurance Review and Assessment Service to perform the entrust agreement, whether the medical facility that provided medical care may directly file a claim for the payment of motor vehicle insurance medical fees against the insurance company, etc. (affirmative)
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