Insurance Planner Hospitalized in Korean Medicine Clinic After Side Mirror Collision [Seocho-dong Legal Story]

"The defendant only received inpatient treatment through a Korean medicine doctor's care, and it was not 'excessive treatment.' Considering that his weight exceeds 100 kg and he was already receiving treatment for another traffic accident, the possibility of injury was higher than that of other passengers." (Claim of the defendant and defense attorney)

On March 29 last year, a bus carrying passengers in Gangnam-gu, Seoul, had a minor collision with the side mirror of a Morning passenger car in the adjacent lane.

Insurance planner A (42, male) was on the bus. He told the insurance company, "My foot was sprained and my chest hit due to the bus's sudden stop. My waist and foot hurt." "At the time, I was looking at my phone when suddenly there was a 'bang,' and my head also hit the window. My neck hurt." From the day after the accident, he was hospitalized for about two weeks at a Korean medicine clinic in Yongsan-gu, about 1.2 km from his home.

A received a total of 4.2 million won in insurance money over 14 claims related to this accident. The prosecution indicted A on charges of violating the Insurance Fraud Prevention Act, stating, "He defrauded insurance companies by receiving excessive treatment and inpatient care for a minor collision."

In court, A's side strongly denied the charges. The defense attorney argued, "There is no evidence that the defendant exaggerated or falsely reported symptoms to the Korean medicine doctor to receive false treatment," and "Considering the defendant's weight and previous treatment records, it cannot be concluded that no injury occurred."

The first trial resulted in a 'guilty' verdict. According to the legal community on the 29th, Judge Park Hye-jung of the Seoul Central District Court Criminal Division 19 stated, "It is recognized that the defendant defrauded insurance companies and had the intent to commit fraud," and recently sentenced A to a fine of 3 million won.

She added, "According to CCTV footage and the National Forensic Service's appraisal, the vehicle did not shake significantly at the time of the accident, and there was no shaking to the extent that the defendant's head or body hit the bus's interior structures. The defendant's statements do not match this and are inconsistent." The average speed of the bus before the accident was 3 km/h.

Judge Park said, "The defendant's health condition at the time does not justify the necessity of inpatient treatment," and judged that A exaggerated the damage to the insurance company and the Korean medicine clinic. Various treatments received at the clinic, such as acupuncture, electrical stimulation therapy, and cupping therapy, were all sufficiently possible as outpatient treatments, and during the hospitalization period, he even went out to Gangnam-gu, Songpa-gu, Gwanak-gu, Yeoju-si in Gyeonggi Province, and Yecheon-gun in Gyeongbuk Province.

Furthermore, Judge Park stated, "The defendant's crime causes damage to insurance companies and results in losses to many honest insurance subscribers. For hospitals, it enables fraudulent receipt of medical benefits through false treatment, thereby threatening the foundation of insurance and medical systems, making the nature of the crime serious," and explained the sentencing by saying, "The insurance company's damage has not yet been recovered."

A appealed the first trial verdict.