Do You Know the SIU Teams on the Front Lines of the Insurance Fraud War?
Caught: Colluding with Her Boyfriend for a Fishing Rod Insurance Scam
Financial Professionals' Unique Data-Driven Approach Leads to Prosecution
At the forefront of the fight against insurance fraud are SIUs (Special Investigation Units for Insurance Fraud). These are independent teams operated by each insurance company, with a significant portion of their personnel being former detectives. By proactively preventing insurance fraud or referring cases to investigative authorities, they contribute to lowering insurance premiums for the public. Asia Economy conducted an in-depth investigation into the SIUs, which are at the heart of this quiet war against insurance fraud. What they witnessed through the eyes of SIU investigators was both meticulous and cunning.
Chae Kyunghwan, a former detective who has been with the SIU for 17 years and currently serves as the senior investigator in Hyundai Marine & Fire Insurance's auto insurance investigation department, handled a car accident case last November. The incident involved a man in his early 40s, Mr. A, who was driving on a village road near Sejong City when he suddenly collided with a woman in her mid-20s, Ms. B, who had unexpectedly stepped onto the road. Ms. B fell due to the accident and claimed that eight fishing rods she was carrying were broken, demanding insurance compensation. Both personal injury and property damage claims were necessary under Mr. A's insurance. There was no CCTV footage at the scene. Getty Images
The starting point for SIU investigations into insurance fraud is always the scene of the incident. If the evidence collected at the scene and the causal relationship in the statements of the parties involved are insufficient, a full investigation begins. Although SIUs are not law enforcement agencies and therefore have limitations in uncovering the full truth of a case, the synergy between the intuition gained from their detective experience and the analytical approach unique to financial professionals has led to significant successes in dismantling insurance fraud rings.
Chaekyung Hwan, a former detective who has been with the SIU (Special Investigation Unit for Insurance Fraud) for 17 years, currently serving as the senior investigator in the auto insurance investigation department at Hyundai Marine & Fire Insurance, is being interviewed by Asia Economy.
Chae Kyunghwan, a former detective who has been with the SIU for 17 years and currently serves as the senior investigator in Hyundai Marine & Fire Insurance's auto insurance investigation department, handled a car accident case last November. The incident involved a man in his early 40s, Mr. A, who was driving on a village road near Sejong City when he suddenly collided with a woman in her mid-20s, Ms. B, who had unexpectedly stepped onto the road. Ms. B fell due to the accident and claimed that eight fishing rods she was carrying were broken, demanding insurance compensation. Both personal injury and property damage claims were necessary under Mr. A's insurance. There was no CCTV footage at the scene.
After speaking with Mr. A, Chae listened to a recorded call between Ms. B and an employee who had visited the scene and noticed something suspicious. Mr. A operated a fishing tackle shop, and coincidentally, Ms. B's boyfriend also ran a fishing tackle shop. The decisive clue was the voice. Ms. B claimed that she had planned to go on a fishing trip with her boyfriend but could not because her fishing rods were broken, demanding 5 million won in compensation. During the conversation, she briefly handed the phone to her boyfriend, but his voice sounded almost identical to Mr. A's. Chae said, "The moment I heard the voice, I instinctively knew that one person was playing two roles," adding, "That was the reason I decided to refer the case for investigation."
The investigation revealed that Ms. B's boyfriend and Mr. A were the same person. The perpetrator and the victim had colluded to commit insurance fraud in hopes of receiving a large settlement. The total compensation of 5.07 million won for personal injury and property damage was fully recovered.
Scientific Data Collection Leads to Prosecution Despite Non-indictment by Prosecutors
Oh Jungun, Head of the Automobile SIU Department at KB Insurance, who has been working in the insurance industry for 19 years, recently encountered an unusual car accident case. A man in his late 30s, Mr. C, had caused 17 left-turn accidents at intersections using a high-end Mercedes-Benz. By utilizing the Insurance Fraud Detection System (IFDS) and the Integrated Insurance Credit Information System (ICIS), Oh discovered that Mr. C had fraudulently claimed over 100 million won in insurance payouts from 2019 to last year. Oh explained, "Mr. C deliberately caused accidents by colliding with vehicles crossing lanes during simultaneous left turns. It was suspicious to anyone, yet it was very strange that Mr. C had never been investigated by any insurance company or law enforcement agency during that time."
Oh persuaded Mr. C to provide dashcam footage of the accidents. Upon running simulations using video analysis software, Oh found that Mr. C did not intentionally slow down, even in situations where he could clearly see the other vehicle. To further increase the reliability of the analysis, Oh requested an official forensic evaluation from the National Forensic Service through the police. The result also concluded that the accidents were intentional. Based on this, the police forwarded the case to the prosecution with a recommendation for indictment. However, the prosecution dismissed the case, citing insufficient evidence.
Oh did not give up. He requested an additional video analysis from a private forensic agency operated by former members of the National Forensic Service and the Korea Road Traffic Authority. The results once again confirmed Mr. C's intent, based on his awareness of the other vehicle, steering, and acceleration. The findings closely matched those of the National Forensic Service. Oh then petitioned the court, arguing that the prosecution's dismissal was unjust and requesting an order for prosecution, which was ultimately granted.
Oh Jungun, Head of the Automobile SIU Department at KB Insurance, who has been working in the insurance industry for 19 years, is being interviewed by Asia Economy.
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