Health Insurance Fraud Surges in South Korea, Raising Concerns over Financial Stability
Seoul, South Korea – A recent surge in fraudulent health insurance claims is prompting calls for stricter penalties and preventative measures, according too a report presented to the National Assembly. The number of questionable claims has increased dramatically, jumping from 88 to 132 during the same period last year - a five-fold increase.
The escalating fraud involves a range of deceptive practices, including the registration of “ghost patients” who do not exist, inflating hospitalization lengths for increased payments, and duplicate or excessive billing. the korea Health Insurance Review and Assessment Service (HIRA) revealed that some medical institutions have even incorporated deceptive billing techniques into employee salaries. this abuse threatens the financial health of South Korea’s national health insurance system, funded by citizen premiums.
These fraudulent activities are occurring despite current penalties of suspension and fines levied against offending institutions. Though, critics argue these measures are insufficient. The United states, for example, utilizes the ‘Anti-Fair Claims Act’ to recover three times the amount of damages from fraudulent claimants. Germany and Japan employ dedicated organizations to proactively prevent insurance leaks.
“Health insurance finances are public resources operated by the precious premiums that the people have sweated,” stated Kim Ye-ji, a member of the People Power Party. “Health authorities should not just stay caught and collect, and strengthen the unfair claim prevention system.”
The HIRA report signals a growing need for enhanced oversight and more robust deterrents to protect the integrity of South Korea’s healthcare system and ensure responsible use of public funds.
