Probe finds large-scale insurance fraud at hospital

A probe has found large-scale insurance fraud at a traditional medicine hospital involving more than 100 people, the financial regulator said Tuesday.

Around 100 “fake” patients at the hospital are suspected of having made false insurance claims worth about 100 billion won (US$72.3 million), according to the Financial Supervisory Service (FSS).

The hospital allegedly offered to provide treatments that are not covered by insurance, mostly for aesthetic purposes, but issued documents saying the patients received treatments for injuries or illnesses that are covered by insurance, allowing them to seek compensation from their private insurers.

The large-scale insurance scam was exposed by the Busan Metropolitan Police Agency, which has “rounded up” a total of 103 people for potential indictment, including the head of the hospital and a nurse, who allegedly issued false medical certificates and diagnoses, according to the FSS.

The FSS and the National Police Agency have been conducting a special inspection to
expose insurance scams after signing an agreement in January to eradicate what they called “organized insurance scams” involving hospitals and doctors, according to the financial regulator.

“People need to be cautious not to be involved in any insurance scams as not only hospitals and brokers that design insurance fraud but the patients who take part in such a scam often get prosecuted,” it said in a press release.

Source: Yonhap News Agency