A nursing home run by the family of Kim Keon-hee lost the first trial in a lawsuit seeking to cancel the National Health Insurance Service's disposition to claw back about 1.4 billion won in long-term care benefits. The court found that because the home inflated employees' working hours to claim benefits, the NHIS's clawback was lawful.
The Administrative Division 5 of the Seoul Administrative Court (Presiding Judge Lee Jeong-won, senior judge) on the 9th ruled against the plaintiff in a suit filed by the operator of Nursing Home A, run by Choi Eun-sun and Kim Jin-woo, seeking to cancel the National Health Insurance Service's disposition to claw back long-term care benefit costs.
The bench found that disguising employees who did not meet the working-hour standard as if they satisfied the requirements and then claiming long-term care benefits constitutes an improper claim by false or fraudulent means under the Long‑Term Care Insurance Act.
The court found no problem not only with the substance of the clawback disposition but also with the procedure. The bench held that the grounds asserted by the National Health Insurance Service were established and that there were no circumstances to deem procedural defects in the process or a deviation or abuse of discretion. In effect, it did not accept any of the core arguments contested by the nursing home.
The dispute began when the National Health Insurance Service determined that Nursing Home A had improperly claimed about 1.44...
A nursing home run by the family of Kim Keon-hee lost the first trial in a lawsuit seeking to cancel the National Health Insurance Service's disposition to claw back about 1.4 billion won in long-...