Former insurance planners were sanctioned for repeatedly committing insurance fraud by disguising plastic surgery as manual therapy. They committed fraud by manipulating medical records and exploiting product loopholes.
According to the Financial Supervisory Service's Insurance Fraud Response Team on the 15th, during inspections of insurance companies and insurance agencies, 39 former insurance planners from 31 companies were found to be involved in insurance fraud and were subjected to sanctions such as suspension of business or cancellation of registration.
In 2018, an insurance planner affiliated with FM Asset Insurance Agency received both manual therapy and plastic surgery but manipulated records to claim only manual therapy in order to reimburse plastic surgery costs. The insurance payout obtained by falsifying medical records amounted to 2.85 million KRW.
An insurance planner from Global Financial Sales Insurance Agency also fabricated having received manual therapy. This planner, who operated a manual therapy room at a Korean medicine hospital, had skin care specialists and massage therapists without physical therapist licenses perform massages, then issued false medical receipts claiming manual therapy, helping to embezzle approximately 260 million KRW in insurance money before being caught.
An insurance planner from InsuCheck Dangsan Insurance Agency disguised receiving nutritional injections (commonly called 'cocktail injections') for cosmetic improvement in 2015 as being prescribed immune boosters for menopausal treatment to fraudulently claim insurance money.
Insurance planners formerly employed by major insurers such as Samsung Fire & Marine Insurance, Kyobo Life Insurance, Meritz Fire & Marine Insurance, KB Insurance, and NongHyup Property & Casualty Insurance were also caught committing insurance fraud.
In 2018, an insurance planner affiliated with KB Insurance who assaulted another person causing fractures exploited the fact that the ‘family daily life liability insurance’ they subscribed to did not cover assault injuries. This planner fabricated the incident as if they had pushed the other person while falling, rather than assaulting them, to claim insurance money, and was caught by the Financial Supervisory Service.
Additionally, an insurance planner formerly with Samsung Fire & Marine Insurance claimed 6.54 million KRW in insurance money after receiving inpatient treatment at a Korean medicine hospital in 2018, despite the pain being minor and not requiring hospitalization.
Earlier in June, the Financial Supervisory Service’s Insurance Fraud Response Team announced that the number of patients reported for insurance fraud related to manual therapy increased by 110% over three years, from 679 in 2019 to 1,429 in 2022. Specifically, cases of receiving procedures such as plastic surgery, skin beauty treatments, and nutritional injections, then falsely claiming insurance money by pretending to have undergone manual therapy covered by indemnity insurance, have increased.
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