Eunkyung Kim, Head of FSC, "Information Sharing Between Public and Private Sectors Effective in Reducing Insurance Payment Leakage"

Launch of the "Public and Private Insurance Joint Investigation Council"

[Asia Economy Reporter Park Sun-mi] "If information sharing between public and private insurance expands, the leakage of insurance payments due to double claims or false claims will be greatly reduced."

On the 25th, as the Financial Supervisory Service (FSS) launched the ‘Public-Private Insurance Joint Investigation Council’ for joint response to insurance fraud with the National Health Insurance Service (NHIS), Kim Eun-kyung, Director of the Financial Consumer Protection Department (FCPD), said in her greeting, "This occasion to strengthen cooperation between public and private insurance is sincerely hoped to be an opportunity not only to eradicate insurance fraud, which has emerged as a social issue, but also to make the public and private social safety nets stronger for all citizens."

Director Kim of the FCPD stated, "The FSS achieved results by detecting over 880 billion won worth of insurance fraud in 2019 through planned investigations in vulnerable areas of insurance fraud, advancement of the Insurance Fraud Analysis System (IFAS), and administrative actions against insurance industry workers involved in fraud. However, these results mean that an enormous scale of insurance fraud, which is difficult even to estimate, is still being committed."

She added, "The methods are becoming increasingly sophisticated and organized, making detection more difficult," and explained, "Due to excessive medical use and overtreatment, the insurance premium burden on the majority of citizens is increasing, and illegal or unreasonable issues are occurring systematically in the medical field, so there is a growing need for strict management from a healthcare perspective as well."

Director Kim emphasized that what is most urgent is close cooperation among related institutions. She stressed, "If information sharing between public and private sectors expands, not only will the leakage of insurance payments due to double or false claims be greatly reduced, but also the effectiveness of insurance fraud prevention and detection can be significantly enhanced if each institution shares accumulated investigation techniques and actively operates a joint response system."

She continued, "Going forward, it is necessary to effectively operate joint investigation processes among related institutions and continuously discover themes suitable for joint investigations to strengthen organic responses," and urged, "In the long term, ways to utilize big data and further solidify cooperative relationships should also be broadly explored."

On this day, the FSS launched the ‘Public-Private Insurance Joint Investigation Council’ for joint response to insurance fraud with the National Health Insurance Service. The two institutions will hold regular meetings of the council and conduct joint investigations on large-scale insurance fraud involving private insurance and health insurance. In particular, they will promote planned and ongoing investigations into false or double claims for medical benefits in private insurance and health insurance. They also plan to strengthen investigation capabilities by sharing investigation techniques and educational information held by each institution related to insurance fraud investigations. After discovering and investigating possible joint investigation themes and analyzing suspicious points, they intend to request investigations by law enforcement agencies.

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