Surge in 'Livelihood Insurance Fraud' Amid COVID-19 Cold Wave... 28.3% Increase Among 10s and 20s

Increase in Fraudulent Injury and Disease Diagnoses such as False Disability and Diagnosis
Fraudulent and Excessive Claims by Hospitals and Repair Shops Also Rising

Amount Detected for Insurance Fraud in the First Half of the Year (Source: Financial Supervisory Service)

[Asia Economy Reporter Oh Hyung-gil] The amount of insurance fraud detected in the first half of the year reached a record high of 452.6 billion KRW. Due to the impact of the COVID-19 pandemic, false hospitalizations decreased, while one-time insurance frauds such as false disabilities increased.

Some hospitals have been encouraging false or excessive treatments, and the proportion of 'livelihood-type insurance fraud' by unemployed, day laborers, and food service workers has increased.

According to the insurance fraud detection status announced by the Financial Supervisory Service on the 22nd, the amount of insurance fraud detected in the first half of the year was 452.6 billion KRW, an increase of 9.5% (39.2 billion KRW) compared to the same period last year.

The number of people detected was 47,417, an increase of 10% (4,323 people) compared to the same period last year.

Among all insurance fraud cases, fraud involving non-life insurance accounted for 92.3% (417.8 billion KRW), while life insurance accounted for 7.7% (34.8 billion KRW).

Among the detected cases, 71% were small-amount insurance frauds involving 5 million KRW or less.

By type of fraud, 'false or excessive accidents' that distort the facts of insurance incidents or exaggerate damages (300.3 billion KRW) accounted for 66.4% of all detections, 'intentional accidents' (66.4 billion KRW) accounted for 14.7%, and 'exaggerated damage accidents' (40.7 billion KRW) accounted for 9%.

Among false or excessive accidents, false hospitalizations (29.3 billion KRW) decreased by 30.3% compared to the same period last year, while false disabilities (13.7 billion KRW) and false diagnoses (2.7 billion KRW) each increased by more than 30%.

In intentional accidents, intentional car collisions increased by 40.9% compared to the same period last year, and among exaggerated damage accidents, hospital overbilling increased by 431.6%, and repair shop overbilling increased by 92.4%.

Insurance Fraud Detection Amount by Age Group in the First Half of the Year (Source: Financial Supervisory Service)

Increase in Insurance Fraud by Unemployed, Day Laborers, and Food Service Workers

The occupations of those detected for fraud were similar to the same period last year, with office workers (18.5%), unemployed and day laborers (10.4%), and full-time homemakers (10.4%) in that order. However, insurance fraud by related professionals such as insurance planners, medical personnel, and automobile repair workers decreased, while fraud by unemployed, day laborers, and food service workers surged.

By age group, those in their 40s and 50s accounted for 44.2% (20,958 people) of detections, while insurance fraud among people in their teens and twenties increased by 28.3% compared to the same period last year, and fraud among seniors aged 60 and above showed a continuous upward trend.

Among those detected, males accounted for 67.9% (32,203 people) and females 32.1% (15,214 people).

The number of males detected for automobile insurance fraud such as drunk driving, unlicensed driving, and driver substitution (22,087 people) was 3.8 times higher than females (5,768 people).

The Financial Supervisory Service plans to strengthen investigations into insurance fraud through close cooperation with investigative agencies, the National Health Insurance Service, and other related organizations to prevent financial leakage in health insurance and private insurance caused by insurance fraud, thereby protecting the public from damage.

An official from the Financial Supervisory Service warned, "Not only acts that intentionally cause accidents but also cases where even small amounts are manipulated or altered in accident details to claim insurance money constitute insurance fraud. The careless thought that 'this small amount is okay' leads to insurance money leakage, causing economic damage such as premium increases for honest policyholders."

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