Ministry of Health and Welfare to Develop Pension Fraud Detection Model..."Preventing Financial Leakage"

The Ministry of Health and Welfare announced on the 1st that it will strengthen the management system for fraudulent claims to prevent financial leakage in the National Pension and Basic Pension.

Since last year, the Ministry of Health and Welfare has been working with the National Pension Service to review the management system for fraudulent claims in the National and Basic Pensions and to prepare necessary improvement measures. This follows the detection in January of a case where a child concealed the death of their mother and received pension benefits for two years. (Reference article: [Exclusive] "Catch fraudulent claims"... Revising the monitoring system for National and Basic Pensions)

The government has decided to strengthen cooperation between the management and investigation systems of the National Pension and Basic Pension. As of the end of last year, approximately 2.9 million people were receiving both National and Basic Pensions simultaneously. However, since the post-payment management systems for the two pensions are separate, the results of verification investigations were not being closely shared. Going forward, the investigation results will be shared, and joint investigations will be conducted to reduce the burden on recipients.

Additionally, based on big data such as existing payment databases and cases of fraudulent claims, a ‘fraudulent claims prediction model’ will be developed, and a ‘non-face-to-face investigation system’ will be implemented to improve investigation efficiency. Along with this, the National Pension will add health examination data from health insurance, and the Basic Pension will link nursing care benefit data from health insurance as monitoring data to select recipients more precisely.

The Ministry of Health and Welfare plans to pursue legal amendments to support related policies in the second half of this year.

Lee Seuran, Director of the Pension Policy Bureau at the Ministry of Health and Welfare, explained, “The National and Basic Pensions are systems funded by insurance premiums and taxes,” adding, “We will manage and operate them with greater responsibility to build a trusted pension system.”