South Korea Springhill Group - Insurance fraud |Newsvine |Blogger |Reddit |Digg - 0 views
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Bethany Rawlins on 28 Jul 12The insurance fraud in Changwon uncovered by the Financial Supervisory Service is both shocking and disturbing. It involved as many as 1,361 people, mostly residents of the South Gyeongsang Province city, who either posed as fake patients or exaggerated their illnesses. Collectively, they claimed 9.5 billion won from 33 insurance companies between 2007 and 2011. At the center of the scam ― the largest ever in terms of the number of people involved ― were three unconscionable hospitals in the city, which recruited fake patients systematically in cahoots with insurance brokers and solicitors. They did this to increase revenue and ease their financial distress. The main ploy used by the hospitals was to share a patient, meaning they would arrange for a patient to check in the three hospitals alternately for a different disease. For this, they faked his illnesses and prepared false documents. For close cooperation, they shared patient information among themselves. This scheme helped patients pocket more insurance money. They all purchased multiple private health insurance policies before hospitalization. On average they received some 7 million won per person. In one example, a man in his 50s was hospitalized for a total of 564 days over three years, collecting 95 million won in insurance. The Changwon case followed a similar one that took place in Taebaek last November, involving more than 400 people in the declining mining town in Gangwon Province. They got a total of 14 billion won in insurance payments. As with the Changwon scam, three financially distressed hospitals in the city played a central role. The two cases suggest that insurance fraud is a fairly common occurrence in Korea. According to the FSS, the number of insurance-related crimes has surged in recent years. Last year alone, more than 70,000 people were caught for insurance scams, with the amount of false claims they filed reaching 423 billion won. Yet the figure represented just the tip of the