Seoul, South korea – Reward payments for reporting unfair health insurance claims in South Korea surged in the first half of 2025, reaching KRW 400 million – a critically important increase despite a recent overall downward trend in both reported cases and reward amounts. The rise comes as confirmed instances of unfair claims identified through field surveys continue to climb dramatically, prompting calls for increased investigative resources.
from KRW 336 million in 2020, reward payouts dipped to KRW 354 million in 2022 and KRW 130 million in 2023 before partially recovering to KRW 229 million in 2024. The latest figure, KRW 400 million through the first six months of 2025, represents a substantial jump, even exceeding the full-year totals of recent years. Concurrently, the number of reported unfair claims has decreased, falling from 126 cases in 2023 to 95 in 2024 and 66 in the first half of 2025.
This apparent disconnect coincides with a sharp increase in the value of unfair claims uncovered through field surveys conducted by the Health Insurance Review and Assessment service (HIRA). These surveys revealed KRW 7.61 billion in unfair claims at 461 institutions in 2020, escalating to KRW 21.5 billion at 514 institutions in 2023, and further rising to KRW 37.79 billion at 612 institutions in 2024.
Representative Nam In-soon has urged an increase in the ratio of local investigation agencies to 2% to bolster both effectiveness and follow-up management. “In order to ensure that the health insurance finances raised with the people’s precious insurance premiums are used wisely without being leaked…to further promote reporting of false and unfair claims and confirmation of medical expenses,” she stated.
The Ministry of Health and Welfare is also taking action, planning to revise the National Health Insurance Act enforcement ordinance to raise the maximum reward limit from KRW 2 billion to KRW 3 billion. The Ministry operates an unfair claim detection system and conducts on-site investigations to prevent financial leakage.
