Kathmandu. In a shocking incident, a man in South Korea’s Busan city has been accused of embezzling millions of insurance money by submitting fake patient and hospital documents. The incident came to light after Busan police arrested some members of the gang involved in the insurance fraud.
The Criminal Investigation Unit of the Busan Metropolitan Police Agency on November 26 charged 13 people, including a 20-year-old man, for violating the Insurance Fraud Prevention Act. A total of 68 fake patients, including a 30-year-old man, have been kept in police custody.
The main accused and his accomplices are suspected to have claimed insurance payments worth about 300 million RWON (about Rs 2.91 crore) from insurance companies by creating fake patients and creating fake documents and billing medical expenses from hospitals.
The gang had been posting recruitment ads for fake patients through an illegal and high-paying job platform called ‘Heads Cafe’. When someone in urgent need of cash contacted the gang, the gang would invite them to a Telegram chat room and lure them with the promise of 40-50 percent of the insurance payment.
In the past, gang leaders would send gang members to hospitals for legitimate treatment. They then used the original diagnosis document and medical expense receipt as templates. The title, the disease, and the name of the doctor were kept unchanged. Whereas, the patient’s name and resident registration number were replaced with fake patient names and fake documents were created.
It has been reported that fake patients claim 10 lakh to 20 million Korean won per insurance. Some patients repeated the process four to five times, Busan police said. “As a result, more than 200 million Korean won was collected in medical expenses,” Busan police said, adding that 10 hospitals across the country, including Suwon in Busan, Gyeonggi province and Gyeonju in northern Gyeongsang province, were involved in the fraud. ’
The police said they took advantage of the fact that insurance payments were low and that insurance companies were unable to verify the authenticity of documents submitted to the hospital at the time of the claim. The gang leaders also recruited some fake patients as key members and assigned them the roles of managers, mediators and recruiters.
According to a Busa police official, the incident resulted in unnecessary insurance payments and increased the insurance premium of the honest insured. “We plan to continue tracking malicious insurance fraud members and fake patients who have fled abroad or refused to report,” the official said.
