Insurance Industry "Expansion of Reporting Period and Rewards for Cataract and Other Insurance Frauds"

[Asia Economy Reporter Changhwan Lee] The insurance industry announced on the 14th that it will expand and reorganize the 'Special Insurance Fraud Reporting and Reward System' jointly conducted with the Financial Supervisory Service.

The General Insurance Association and the Life Insurance Association operated the 'Special Cataract Insurance Fraud Reporting and Reward System' from April to June in collaboration with the National Police Agency, Financial Supervisory Service, and the Korean Ophthalmological Society to strengthen investigations into cataract insurance fraud.

As a result, reports of insurance fraud allegations were received against 35 problematic ophthalmology clinics, and for some clinics where the cases were serious and evidence was clear, investigations were requested from the authorities.

The General Insurance Association and Life Insurance Association announced that, together with the Financial Supervisory Service, they will expand the scope of the 'Special Insurance Fraud Reporting' from the existing cataract-related cases to include other problematic non-reimbursable treatments, and extend the reporting period until the end of the year to eradicate insurance fraud and establish a sound insurance market order.

The problematic non-reimbursable treatments include, besides cataracts, HIFU, thyroid treatments, physical therapy, and cosmetic surgery. The reporting reward has also been increased from a maximum of 30 million KRW to 50 million KRW.

To promote the special reporting system, the associations emphasized that reports with clear insurance fraud allegations and recognized seriousness will undergo separate review and a portion of the special reward will be paid in advance. They also plan to conduct public awareness campaigns in major areas of Seoul with high foot traffic, such as Gangnam and Gwanghwamun.

An association official stated, "If you participate or become involved in insurance fraud activities by brokers who demand false medical certificates from medical institutions or offer financial benefits, you may be criminally punished as an accomplice. If you receive insurance fraud proposals or become aware of suspicious cases, please actively report them to the Financial Supervisory Service or the insurance company's insurance fraud reporting center."

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