Minor Accident but Even 'Gongjin-dan'? Auto Insurance Fraud Involving Korean Medicine Hospitals Soars, You Could Be Implicated Too!
Even for a minor traffic accident, if you fall for the sweet temptation of "It's all covered by insurance," or "Feel free to be hospitalized and even take Gongjin-dan," you could unwittingly become an accomplice in 'insurance fraud'. Recently, the Financial Supervisory Service (FSS) issued a consumer alert as auto insurance fraud targeting traffic accident patients, in collaboration with some Korean traditional medicine hospitals and brokers, has sharply increased. We provide detailed information on the fraud methods, their risks, and precautions for prevention.
1. Surging 8-fold in a Year! The Reality of Auto Insurance Fraud Involving Medical Institutions
- Serious Increase: Auto insurance fraud involving medical institutions surged more than 8 times from 1.7 billion won in the first half of last year to 14 billion won in the first half of this year. This is a serious level that calls for caution.
- Main Types: The majority consists of exaggerated billing for hospital treatment, with cases involving Korean traditional medicine hospitals particularly prominent.
2. 'Gongjin-dan Temptation': Subtle Fraud Methods of Korean Medicine Hospitals
The Financial Supervisory Service warned that some Korean traditional medicine hospitals are committing insurance fraud in collusion with brokers using the following methods:
- Inducement of False Hospitalization: Despite minor accidents where outpatient treatment would suffice, brokers encourage patients to undergo unnecessary hospitalization. False hospitalization is processed by concealing facts like leaving or staying out, and manipulating hospitalization records.
- Excessive Treatment and Over-prescription: Patients who could be sufficiently treated as outpatients are unnecessarily hospitalized for extended periods, or herbal medicines and tonics (like Gongjin-dan) are excessively prescribed to inflate treatment costs.
- Illegal Dispensing/Prescription of Herbal Medicine (Cheop-yak):
- Prescription Without Face-to-Face Consultation: Traffic accident patients must receive prescriptions tailored to their condition through a face-to-face consultation with a doctor, but this is ignored, and hospitalization or prescriptions are made without such consultation.
- Pre-prepared Cheop-yak: Providing pre-prepared herbal medicines regardless of the patient's condition is illegal. Prescribing the same herbal medicine to all patients also falls under this category.
- Hospitalization Processing Without Weekend/Night Treatment: Some hospitals claim insurance money by processing patient hospitalization without actual treatment on weekends or at night.
- Role of Brokers: Brokers assist organized fraud by taking department store gift certificates and free treatment vouchers in return for patient referrals.
3. 'Unknowingly' You Could Become an Accomplice in Insurance Fraud!
The FSS strongly warned that a complacent thought like "It's fine if the hospital tells me to" could lead to insurance fraud, which is a serious crime.
- Patient Implication: If you falsely hospitalize for a minor accident or consent to excessive treatment, you yourself could be prosecuted for insurance fraud.
- Reporting for Business Activities: Even if a hospitalized patient engages in business activities such as delivery or taxi driving during their outings, they become subject to reporting for suspected insurance fraud.
- Consenting to Illegal Herbal Medicine: Consenting to receive herbal medicines without a face-to-face consultation, or herbal medicines prescribed regardless of the patient's condition, can also implicate you in insurance fraud.
4. Active Reporting Necessary for Suspected Insurance Fraud
- Reporting Channels: If you suspect false claims such as false hospitalization or the provision of herbal medicines, you should immediately report it to the relevant insurance company or the Financial Supervisory Service (dial 1332 without area code).
- Ultimately, Consumers Bear the Damage: Insurance fraud is a serious crime that ultimately leads to increased insurance premiums for the vast majority of honest policyholders, harming everyone.
Don't Fall for the 'Insurance Fraud' Trap Hidden Behind Sweet Temptations!
A minor traffic accident can happen to anyone, but insurance fraud by some medical institutions and brokers using it as an excuse is a serious crime that harms the entire healthy system of society. Do not be misled by sweet temptations like "It's all covered by insurance" or "Feel free to be hospitalized and take Gongjin-dan", and firmly refuse unnecessary excessive treatment or false hospitalization. The complacent thought of "it won't matter if it's just me" is strictly prohibited. Remember that the damage from auto insurance fraud ultimately leads to increased insurance premiums for all of us, and if you find yourself in a suspicious situation, do not hesitate to report it to help protect a healthy insurance market.
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