Kim Sung-won "Out of 104.6 billion won in fraudulent industrial accident claims, only 8.9 billion won has actually been recovered"

Analysis of Fraudulent Industrial Accident Insurance Claims... This Year's Recovery Rate Only 1.9%
"51.5% of Fraudulent Claims from Office-Manager Hospitals... Impacted by Poor Recovery Performance"

Kim Seong-won, Member of the People Power Party [Image source=Yonhap News]

[Asia Economy Reporter Kim Bo-kyung] From 2015 to June of this year, out of 104.6 billion KRW that should have been recovered due to fraudulent claims of industrial accident insurance benefits, only 8.9 billion KRW (8.5%) has actually been recovered. The recovery rate for fraudulent claims this year was only 1.9%.

On the 21st, Kim Seong-won, a member of the National Assembly’s Environment and Labor Committee from the People Power Party, analyzed the 'Annual Status of Industrial Accident Insurance Fraudulent Claims (2015 to June 2020)' submitted by the Korea Workers' Compensation and Welfare Service. The analysis revealed that out of 104.6 billion KRW in decided recoveries for fraudulent industrial accident insurance claims, only 8.9 billion KRW was actually recovered. This means less than 10% of the total amount collected was recovered.

During this period, there were a total of 2,388 cases of fraudulent industrial accident insurance claims, amounting to approximately 52.6 billion KRW. According to the Industrial Accident Compensation Insurance Act, twice the amount fraudulently claimed must be collected.

The actual recovery rates for fraudulent claims by year were 16.9% in 2015, 4.7% in 2016, 13.1% in 2017, 8.2% in 2018, 6.4% in 2019, and 1.9% in 2020.

It has been pointed out as a factor undermining the soundness of the Industrial Accident Compensation Insurance and Prevention Fund, as less than 5% of the fraudulent claims from 2016 have yet to be recovered.

Among these, fraudulent claims originating from so-called "samujang hospitals" (office-holder hospitals), which are illegal medical institutions, accounted for 51.5%, having the greatest impact on poor recovery performance. A samujang hospital refers to a hospital established and operated by a person who is not authorized to open a medical institution, by illegally hiring medical personnel or obtaining corporate approval under false pretenses.

These hospitals provide low-quality medical services such as overcrowded beds for the purpose of profit rather than patient health, and cause social problems by increasing the national medical expenses burden through excessive treatment.

Assemblyman Kim Seong-won stated, "Even when samujang hospitals are detected, the data only reaches the Ministry of Employment and Labor after criminal and administrative actions by the Ministry of Health and Welfare and judicial authorities, making recovery difficult due to closures or asset concealment." He emphasized, "The Ministry of Employment and Labor and the Korea Workers' Compensation and Welfare Service must strengthen cooperation systems with the prosecution, police, and National Health Insurance Service, and simultaneously make efforts to improve recovery rates by expanding the collection period and other measures."

This content was produced with the assistance of AI translation services.