Chuncheon District Court Sentences 1 Year Imprisonment for Insurance Fraud Charges
A man in his 60s who repeatedly admitted and discharged himself from the hospital for nearly 1,000 days despite being able to receive outpatient treatment was sentenced to prison for insurance fraud after claiming 100 million won in insurance money.
On the 17th, the Chuncheon District Court Criminal Division 1 (Judge Shin Dong-il) sentenced Mr. A (60), who was indicted for violating the Special Act on the Prevention of Insurance Fraud, to one year in prison, according to Yonhap News on the same day. Mr. A was tried on charges of being hospitalized for a total of 982 days from June 2017 to November 2022 despite being able to receive outpatient treatment, and receiving a total of about 118 million won from the insurance company in 33 installments under the name of hospitalization medical expenses and daily hospitalization allowance. Diagnosed with multiple myeloma in 2014, he received long-term inpatient treatment to claim insurance money despite the possibility of outpatient treatment instead of inpatient care.
Mr. A denied the charges, claiming that "he received appropriate inpatient treatment based on the doctor's medical judgment." However, the court ruled that even if there were some reasons to receive insurance money or certain diseases, insurance fraud was established because he abused this to receive excessive insurance money beyond the actual amount. The court also found it unusual that Mr. A repeatedly admitted himself to the same nursing hospital despite no improvement in his condition, receiving only simple treatments besides immune therapy injections, and that he received outpatient treatment at a university hospital. Furthermore, considering that Mr. A went out 107 times during his stay at the nursing hospital and that communication records revealed he was far from the hospital, the court deemed his behavior unnatural for a patient receiving inpatient treatment.
The court pointed out, "Insurance fraud not only worsens the financial condition of insurance companies but also leads to additional premium increases, causing harm to honest policyholders and increasing overall social losses, yet the defendant shows no remorse." Regarding the sentencing, the court explained, "However, we took into account that Mr. A has no prior record of similar crimes and that he did not receive insurance money for completely fictitious diseases throughout the hospitalization period."
Meanwhile, in May, a man in his 40s who exaggerated symptoms to stay hospitalized for a long time and claimed nearly 100 million won in insurance money was also sentenced to prison. The Ulsan District Court Criminal Division 7 (Judge Min Han-gi) sentenced Mr. B, who was indicted for violating the Special Act on the Prevention of Insurance Fraud, to six months in prison.
Mr. B was charged with inflating the severity of a back disease and claiming about 96 million won from three insurance companies in July 2015. Although he only needed to be hospitalized for about 14 days, he exaggerated his pain to the doctor and was hospitalized for a total of 58 days. During the trial, Mr. B argued that his hospitalization was not fake because it was based on the doctor's diagnosis, but the court rejected this. The court reasoned that since doctors have no choice but to consider the symptoms and pain levels reported by patients, if patients exaggerate, it inevitably affects the doctor's judgment.
The court ruled this way considering that Mr. B traveled abroad before and after hospitalization, went out to drink alcohol during hospitalization, and other patients testified that he did not take his medication properly during hospitalization. The court explained the reason for the prison sentence, stating, "Mr. B appeared to be able to walk and carry out daily activities as he went out daily and drank alcohol," and "Despite the serious nature of the crime, he denies the offense."
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