Lee Chan-jin, Governor of the Financial Supervisory Service: "Medical institutions involved in insurance fraud to be punished severely... prompt investigation requested"

[Financial News] Lee Chan-jin, Governor of the Financial Supervisory Service, emphasized on the 16th, "If suspicions of insurance fraud by medical institutions making improper claims are detected, we will promptly request an investigation to set an example."
Lee Chan-jin made these remarks at the signing ceremony of a business agreement between the Financial Supervisory Service and HIRA held at the Financial Supervisory Service headquarters in Yeongdeungpo District, Seoul, on the same day, aimed at eradicating insurance fraud and improper billing by medical institutions. Through this agreement, the Financial Supervisory Service decided to strengthen information sharing with HIRA to detect related crimes and to operate a working group for specific implementation.
Concerns are mounting that leakage in public and private insurance funds is increasing due to the continued occurrence of insurance fraud exploiting indemnity insurance and Auto Insurance, as well as fraudulent claims by medical institutions. According to the Financial Supervisory Service, the scale of insurance fraud detected last year (in monetary terms) reached 1.1571 trillion won, a 0.6% increase from the previous year and a new all-time high. The number of individuals caught totaled 105,743. Manipulation of accident details, such as the forgery or alteration of medical certificates, accounted for 54.9% (635 billion won), making up more than half of the total. In particular, cases where hospitals overcharged for treatment using Auto Insurance surged by 582.5%, while false accidents accounted for 20.2% (234.2 billion won) and intentional accidents for 15.1% (175 billion won). The Financial Supervisory Service is paying close attention to the rising number of insurance fraud cases involving hospitals and insurance industry employees.
The Financial Supervisory Service and HIRA will utilize data from indemnity insurance and Auto Insurance to respond to abnormal signs such as over-treatment, and will expand monitoring of hospitals that violate medical fee standards. They also agreed to discuss measures to secure funding for review operations and to promote personnel exchanges. SeungKwon HONG, President of HIRA, stated, "This agreement is a meaningful first step toward jointly responding to illegal activities that threaten the soundness of public and private insurance, and creating a health and financial environment that the public trusts."

[email protected] Jo Eun-hyo Reporter