Fraudulent Claims Rampant in Indemnity Insurance... 30,000 Cases Detected Over 3 Years

[Asia Economy Reporter Changhwan Lee] It has been revealed that nearly 30,000 people have been caught for fraud related to indemnity health insurance (실손보험) over the past three years.

According to the Financial Supervisory Service and others on the 2nd, the number of people caught for indemnity insurance fraud from 2018 to 2020 was 30,735.

The largest portion, 34% of those caught, were related to hospitals and brokers.

Indemnity insurance fraud is on the rise. In 2020, the number of people caught for indemnity insurance fraud was about 13,800, an 11% increase compared to the previous year.

From 2018 to 2020, the amount of indemnity insurance fraud reached 164.3 billion KRW. In 2020 alone, the fraud amount was 53.7 billion KRW, a 30% increase from the previous year.

Indemnity insurance is a product that comprehensively covers medical expenses borne by patients, and it is a social problem as it often leads to organized insurance fraud involving collusion between hospitals and brokers.

Due to indemnity insurance fraud, insurance companies suffer losses amounting to trillions of won annually, which ultimately leads to increases in indemnity insurance premiums, thereby increasing consumer damages.

This year, insurance companies raised indemnity insurance premiums by an average of about 14%.