FSS to Focus on Investigating 'Habitual Insurance Fraud'... Emphasis on Vulnerable Products (Comprehensive)

Focus on Specific Products, Diseases, and Coverage... Standardize After Analyzing Results

[Asia Economy Reporter Wondara] The Financial Supervisory Service (FSS) will conduct a special investigation into insurance fraud. The scope of this special investigation includes areas where insurance fraud has recently surged, such as cataracts, alveolar bone (the bone supporting teeth), injury treatment riders, golf insurance, and shared vehicles.

According to financial authorities on the 15th, the FSS Insurance Fraud Response Team will carry out the special investigation until the end of the year based on the analysis results of vulnerable insurance products and sectors to insurance fraud conducted last year. The FSS Insurance Fraud Response Team stated, "Insurance fraud is concentrated on specific products, diseases, and coverages depending on the insurance company," adding, "We will analyze the causes of insurance fraud by conducting empirical analysis of the methods mainly used by fraudsters and prepare countermeasures."

According to the FSS's analysis of the proportion of insurance fraudsters' claims over the past three years compared to total accident insurance payouts last year (with 92,538 individuals caught as of the end of 2019), insurance fraud was concentrated in specific product, disease, and coverage groups. By product, insurance fraud involving driver insurance was the highest at 6.0%. This was followed by fire insurance (3.9%), term insurance (3.8%), travel insurance (3.3%), and whole life insurance (3.0%). Among diseases, self-harm and burns accounted for the highest proportion at 8.0%, followed by transportation-related injuries, drug intoxication and suffocation, and outpatient injuries and deaths. Coverages with high proportions of insurance fraud included disability (12.1%), nursing and care (5.4%), fixed hospitalization benefits (4.9%), death (3.1%), and emergency treatment (2.7%). The coverages with the largest amounts of insurance fraud were indemnity treatment (147.7 billion KRW), hospitalization (128.5 billion KRW), diagnosis (124.0 billion KRW), and disability (108.8 billion KRW), in that order.

In cases of insurance fraud involving shared vehicles, methods such as renting a car without face or real-name verification and deliberately colliding with other vehicles were found. Regarding golf insurance, it is still known that many cases involve faking hole-in-ones to claim congratulatory money. Insurance companies have been found to have either stopped selling these products, reduced coverage amounts, or set exemption periods.

An official from the Insurance Fraud Response Team said, "Insurance companies have operated insurance fraud impact assessments formally due to weakened sales power, resulting in insufficient effective measures," adding, "We will focus investigative personnel on insurance fraud-vulnerable products such as cataracts, alveolar bone, injury treatment riders, golf insurance, and shared vehicles, analyze the investigation results, and promote regulation if necessary."

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