Financial Supervisory Service Takes Strong Action Against Cataract Scams: Large Rewards Offered for Informing on Fraudsters

[Asia Economy Reporter Changhwan Lee] In response to the recent surge in excessive cataract treatments, financial authorities have stepped up investigations and introduced reward payments as special measures.

On the 5th, the Financial Supervisory Service (FSS) announced that it, together with the Korean Ophthalmological Society, communicated concerns regarding the recent sharp increase in cataract surgery insurance claims to ophthalmology clinics and hospitals nationwide and requested their cooperation.

This is due to the rapid rise in claims for actual expense insurance payments related to cataract surgeries (cataract surgery insurance payments) since January of this year.

From January to March 11 of this year, the payout for cataract surgeries by domestic non-life insurance companies reached 268.9 billion KRW, marking an all-time high. As of February, the proportion of cataract surgery claims among total actual expense insurance claims was 12.4%, up from 9.1% last year.

The FSS explained that claims for cataract surgery insurance payments have surged mainly in specific medical institutions in certain regions, and cases suspected of excessive treatment are also increasing.

Accordingly, they emphasized the operation of a special reporting and reward system for cataract insurance fraud. The focused reporting period is from the 18th of this month to the 31st of next month, and the targets for reporting are those suspected of involvement in cataract insurance fraud at ophthalmology clinics and hospitals.

For reports made during the special reporting period, in addition to the existing reward (up to 1 billion KRW), an additional special reward of up to 30 million KRW will be paid during the investigation process. Reports can be submitted to the FSS and the insurance companies' insurance fraud reporting centers.

An FSS official stated, "Insurance payout leakage caused by unnecessary excessive treatment results in financial burdens on the National Health Insurance and private insurance companies, thereby increasing insurance premiums for the majority of the public." They added, "Consumers and medical institutions involved may be subject to criminal penalties for insurance fraud and other illegal activities."

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