Financial Supervisory Service Begins Investigation into Hospital-Broker Linked Insurance Fraud with Police Agency and National Health Insurance Service

The Financial Supervisory Service (FSS) announced on the 7th that it has launched investigations and inquiries into three cases of insurance fraud involving hospitals and brokers in collaboration with the National Police Agency and the National Health Insurance Service (NHIS).

Recently, insurance fraud crimes, which cause premium increases for honest policyholders, have been increasingly large-scale and specialized through connections with hospital and broker organizations. Doctors and professional brokers collude to refer and lure hundreds of patients, then issue false medical records and receipts to fraudulently obtain insurance payouts (from insurance companies) and medical benefits (from NHIS).

In response, the FSS, National Police Agency, and NHIS signed a business agreement on the 11th of last month to eradicate insurance fraud and illegally established medical institutions. On the 19th of the same month, they held a joint investigation council meeting to discuss detailed implementation plans.

Financial Supervisory Service building.

They agreed to hold joint investigation council meetings once a month regularly and to further strengthen cooperation and collaboration centered on these meetings. The FSS and NHIS specified investigation methods such as jointly interviewing informants from each institution and periodically sharing information on insurance fraud allegations.

Additionally, the FSS and NHIS shared lists of cases referred for investigation and progress updates, and discussed the need for joint responses or investigative support. The National Police Agency decided to systematically manage the investigation progress of major insurance fraud cases by monitoring them.

These institutions prioritized three cases found to have defrauded both public and private insurance funds as joint investigation cases. Depending on the progress of each case, they promptly began investigations and inquiries, including jointly interviewing informants and discussing necessary investigative support.

An FSS official stated, "For cases reported during the currently operating special insurance fraud reporting period that are related to hospital and clinic insurance fraud, we will conduct joint investigations with the NHIS and take measures such as referring cases for investigation. Subsequently, in connection with the National Police Agency’s special crackdown on insurance crimes, we will strengthen response and investigative support to ensure swift progression to investigations."