Financial Supervisory Service and National Health Insurance Service to Jointly Investigate Large-Scale Insurance Fraud

Launch of the Public-Private Insurance Joint Investigation Council

[Image source=Yonhap News]

[Asia Economy Reporter Oh Hyung-gil] A joint investigation will be conducted to detect insurance fraud involving public insurance, such as the National Health Insurance, and private insurance.

On the 25th, the Financial Supervisory Service announced the launch of the "Public-Private Insurance Joint Investigation Council" in cooperation with the National Health Insurance Service to jointly respond to insurance fraud.

The two organizations will hold regular council meetings and conduct joint investigations into large-scale insurance fraud involving private insurance and the National Health Insurance. In particular, they will promote planned and ongoing investigations into false or duplicate claims for medical benefits under private and National Health Insurance.

Hospital A fraudulently received 536 million KRW in insurance payments by administering obesity treatment injections, which are not covered by insurance, to 252 patients gathered through brokers, then manipulating the claims to appear as cold treatment covered by insurance, or by creating false records indicating outpatient treatment despite patients never visiting the hospital. Additionally, the hospital embezzled 33 million KRW by falsely claiming medical benefits from the National Health Insurance Service.

Furthermore, the agencies plan to strengthen investigative capabilities by sharing investigation techniques and educational information related to insurance fraud investigations.

They intend to identify and investigate potential joint investigation themes, analyze suspicious points, and then request investigations from law enforcement agencies.

A Financial Supervisory Service official stated, "This will help eliminate blind spots in public-private insurance fraud investigations that have not been addressed so far," and added, "We expect that mutual cooperation between public and private sectors will improve the efficiency and effectiveness of insurance fraud investigations."

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