The director of a hospital in Seoul has been referred to the prosecution on charges of disguising cosmetic procedures as pain treatments and fraudulently obtaining over 1.4 billion won in indemnity insurance payouts and medical care benefits.
The Seoul Metropolitan Police Agency's Criminal Mobile Unit announced on the 14th that they have arrested and transferred hospital director A on charges including insurance fraud, and have transferred 130 patients without detention. The photo shows the usage tickets provided by A to the patients. Seoul Metropolitan Police Agency
The Seoul Metropolitan Police Agency's Criminal Mobile Unit announced on the 14th that they have arrested and sent hospital director A to prosecution on charges including insurance fraud, while 130 patients were sent to prosecution without detention.
According to the police, director A, who runs a clinic in Seoul, is accused of processing cosmetic procedures as reimbursable items such as manual therapy and pain injections over the past five years, and issuing false medical record certificates.
After registering dermatology and orthopedics as medical departments, A promoted to patients that the costs of various cosmetic skin procedures could be claimed through indemnity insurance. Patients were encouraged to prepay for procedures in packages of 10 sessions, after which they were issued usage ticket-style vouchers for future reservations, thereby promoting long-term client registration. In some cases, additional cosmetic services were provided if patients introduced acquaintances.
The police conducted a search and seizure at the hospital, securing medical records and, in cooperation with the Financial Supervisory Service and the National Health Insurance Service, meticulously compared the insurance claim records provided to substantiate the charges against those involved. It was found that 20 insurance companies associated with the hospital paid out a total of 400 million won in indemnity insurance based on false documents, and that the hospital fraudulently received approximately 1 billion won in medical care benefits from the National Health Insurance Service.
A police official stated, "Insurance fraud undermines the financial soundness of both public and private insurance, and is a serious crime that increases the burden on honest policyholders through higher premiums." The official also warned, "Do not be deceived by claims that you can get reimbursed for various cosmetic procedures that are excluded from indemnity insurance coverage."
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