"How Much Private Insurance Money Has Leaked?"... Financial Supervisory Service to Conduct Research Project in Second Half of Year

The Financial Supervisory Service (FSS) will promote a research project in the second half of the year to estimate the scale of private insurance payout leakage.

On the 4th, the Financial Services Commission held an 'Insurance Investigation Council' meeting with the Ministry of Health and Welfare, National Police Agency, Financial Supervisory Service, National Health Insurance Service, Health Insurance Review & Assessment Service, Korea Workers' Compensation & Welfare Service, Korea Insurance Research Institute, and the Insurance Association to discuss plans for a research project to estimate the scale of insurance payout leakage by insurance product caused by insurance fraud.

According to the council, the FSS will promote a research project in the second half of this year to estimate the scale of private insurance payout leakage and to identify characteristics and trends of insurance fraud in major overseas countries. Through this, it plans to establish insurance fraud prevention policies and utilize them for joint responses by related agencies.

On this day, the council also reviewed the status of preparations for related systems and institutions under the revised "Special Act on the Prevention of Insurance Fraud." Major amendments to the Special Act include ▲ prohibition of acts such as solicitation and inducement of insurance fraud, ▲ the financial authorities' right to request data for insurance fraud investigations, ▲ establishment of hospitalization appropriateness review standards by the Health Insurance Review & Assessment Service, and ▲ relief for victims of automobile insurance fraud.

The financial authorities are currently building a computerized system that can automatically request review by the Korea Communications Standards Commission for acts of solicitation, inducement, recommendation, and advertisement of insurance fraud, and are consulting with the National Police Agency and others regarding cases of solicitation, inducement, recommendation, and advertisement of insurance fraud that can be referred for investigation.

Regarding the exercise of the right to request data provision, the financial authorities are consulting with related agencies about requests for data necessary for investigating reported cases such as false insurance claims or intentional accidents, including details of medical benefits or data related to the recovery of unjust profits from medical benefits or industrial accident insurance benefits.

In the case of relief for victims of automobile insurance fraud, specific procedures necessary for victim relief, such as methods of notifying the victim of the damage and timing of refunding increased insurance premiums, are being reflected in the Financial Supervisory Service's enforcement rules.