[Asia Economy Reporter Bu Aeri] A total of 61 people have been caught on charges of duplicate or false claims for industrial accident compensation and insurance payments.
The Financial Supervisory Service and the Korea Workers' Compensation and Welfare Service announced on the 17th that they jointly uncovered individuals suspected of fraudulent receipt of insurance payments and industrial accident insurance benefits through a planned investigation of 'commuting accidents' conducted last year.
The Financial Supervisory Service selected workers who received industrial accident insurance benefits for commuting accidents and were suspected of possible fraudulent claims as investigation targets.
The investigation was conducted by integrating industrial accident application details with private insurance claim information, cross-checking accident circumstances, injury locations, and treatment records.
Most of the 61 individuals caught were found to have claimed both industrial accident compensation and insurance payments for the same or adjacent-date accidents but reported different accident details for each.
Looking at major suspicious cases, Mr. A was approved for industrial accident compensation for a commuting accident on April 28, 2021, when he slipped and injured his foot at a subway station. Later, on the same date, he received insurance payments from an insurance company for an accident where he fell on his home veranda and fractured his big toe.
It is illegal to claim industrial accident compensation or insurance payments with accident details that differ from the actual incident. Furthermore, it is fundamentally prohibited to receive overlapping payments for the same type of compensation items between industrial accident insurance and automobile or indemnity insurance.
The Financial Supervisory Service plans to recover improperly paid industrial accident insurance benefits and insurance payments to enhance the soundness of insurance finances.
Additionally, depending on the seriousness of the case, they will select subjects requiring investigation and refer them to investigative agencies.
Moreover, through legislative support for the proposed amendment to the 'Special Act on the Prevention of Insurance Fraud' submitted to the National Assembly, they plan to establish a real-time information-sharing system between public and private insurance.
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