Amendment to the Enforcement Decree of the Special Act on Insurance Fraud Prevention Approved at the Cabinet Meeting
The financial authorities' investigative powers regarding insurance fraud will be strengthened. If it is confirmed that insurance premiums have been increased due to insurance fraud, insurance companies will be required to notify policyholders of the premium increase and the refund procedures for the improperly increased premiums.
On the 30th, the Financial Services Commission announced that the revised Enforcement Decree of the Special Act on the Prevention of Insurance Fraud, containing these provisions, was approved at the Cabinet meeting. The revision will take effect on the 14th of next month.
According to the Enforcement Decree, financial authorities will be able to request necessary data from related organizations such as the National Health Insurance Service and the Korea Workers' Compensation and Welfare Service to investigate insurance fraud.
Additionally, to investigate websites that solicit or encourage insurance fraud, financial authorities can request information from information and communication service providers such as internet portals or social networking service (SNS) providers, including access information of illegal content posters.
The financial authorities plan to actively investigate insurance fraud by securing data necessary for investigating reported cases such as false insurance claims or intentional accidents, including details of medical benefits or the collection of unjust profits from industrial accident insurance.
Furthermore, if there is suspicion of solicitation, encouragement, inducement, or advertising related to insurance fraud, the financial authorities will automatically request review from the Korea Communications Standards Commission or refer the case to the National Police Agency for investigation.
If an insurance company confirms that premiums have been unfairly increased due to insurance fraud related to automobile accidents, it must notify the policyholder or insured person of the improper premium increase and the refund procedures.
Since 2009, insurance companies have voluntarily notified refund procedures. However, from now on, this notification will be institutionalized, and it is expected that the rights of victims of insurance fraud will be more actively protected.
Also, the Health Insurance Review & Assessment Service, which reviews the appropriateness of hospitalizations upon request from investigative agencies, will announce the hospitalization appropriateness review criteria on its website, considering the individual characteristics of patients and medical validity.
© The Asia Business Daily(www.asiae.co.kr). All rights reserved.
