국민건강보험법 제48조 제1항 제1호 보험급여 제한 요건 ‘중과실에 의한 범죄행위로 기인한’에 대한 소고
About Insurance Benefits Restriction Condition of National Health Insurance Act Article 48 Paragraph 1: ‘When He has Through Gross Negligence Caused a Criminal Conduct'
National Health Insurance Act has been enforced all over the People as part of the effort to assure the minimum constitutional human worth and dignity in the aspect of the right to pursue health for preventing misfortune that comes to death without even a chance to be received treatment for illness or injury. Meanwhile auto insurance is compulsory in certain parts in order to promote benefits of everyday life and the rapid recovery of the damage caused by traffic accident when one have negligently driven a car which has become the necessities in daily life. Any injured driver in a traffic accident can be treated by National Health Insurance without getting an auto insurance in various circumstances, but Article 3 paragraph 2 of Traffic Accident Act don't allow exception of criminal punishment when he has driven a car without license, drunken, or tresspassing the centerline, etc. When the injury occured by his own certain negligence is judged to ‘when he has intentionally or through gross negligence caused a criminal conduct or intentionally contributed to the occurrence of an accident' of National Health Insurance Act, insurance benefits can be restricted. Such a restriction could harm the right to pursue happiness and health of People by depriving the poor, who cannot afford to pay, of chances to get treatment. Here we will see benefit restriction by ‘gross negligence' of National Health Insurance Act Article 48 paragraph 1, which has largest portion of such restriction. It is desirable to delete ‘gross negligence' clause from above paragraph and to interpret ‘when' clause restrictively for diminishing confusion of interpreting and guaranteeing the right of health.
목차
I. 서론 II. 중과실의 자손환자에 대한 급여제한 1. 중과실 자손환자에 대한 급여제한 2. 중과실 자손환자에대한 건강보험급여 제한의 검토 3. 법제48조 제1항 제1호 보험급여 제한이 요건의 '중과실에 의한 범죄행위로 기인한'의 검토 4. 중과실 판단기준 5. 중과실에 의한 범죄행위로 '기인한' 때(인간관계) III. '중과실' 자손환자에 대한 급여제한 규정 개선방안 1. 현행법상 해석상의 문제점 2. '중대한 과실'에 의한 범죄행위의'중대한 과실' 삭제 IV. 결론 참고문헌 ABSTRACT
키워드
국민건강보험보험급여제한중과실자동차보험기인한National Health InsuranceInsurance benefits restrictionGross negligenceSelf-inflicted injuryCausation.
대한의료법학회는 “법학계, 법조계, 의료계가 공동하여 의료법학의 학제적 연구와 판례 평석 등을 통하여 전문분야에 있어서의 법률문화 향상에 기여함을 그 목적”으로 하여 1994년 2월에 태동한 이후 1999년 4월 24일에 공식 출범한 이래 2006년 3월 30일 법무부 산하의 사단법인으로 등록된 세계적 수준의 순수 학술단체이다.