Kathmandu. Millions of dollars in dental insurance have been swindled in South Korea. More than 200 members of a large-scale organized insurance fraud group have been prosecuted for their alleged involvement in fraud. <\/p>\n
On June 31, the Seoul South District Prosecutor’s Office charged 200 people, including two dentists, two hospital directors, a consulting director and 12 insurance planners, with violating the Insurance Fraud Prevention Act and medical laws. Two hospital directors, a consulting director and an insurance planner were arrested and prosecuted. <\/p>\n
According to the prosecution, they defrauded nearly 2.2 billion won (about Rs 234.3 million) by inflating the number of teeth they treated over a period of 3 years and 8 months from August 2020 to April 2024. Some dental insurance policies took advantage of the fact that there is no guarantee limit on the number of teeth. <\/p>\n
The dentist committed this crime by falsifying the patient’s medical records managed by the insurance planner. Initially, when an insurance planner referred patients with dental insurance to the dentist, the dentist issued a treatment confirmation. It misstated the number of teeth treated with resins. The patient later received the insurance money with confirmation. <\/p>\n
A kind of ‘return’ method was also used to attract more patients. According to the prosecution, the dentist returned about 30 percent of the fraudulently obtained insurance money to the insurance planner. The crime involved 46 insurance planners, 6 dental executives and 200 patients. As a result, the insurance company lost about 2.2 billion won. <\/p>\n
Prosecutors claim that Insurance Planner A conspired to defraud and implicated a number of dental officers and patients. Some insurance planners, including A, received money and valuables in exchange for referring patients to dentists. “Insurance fraud increases insurance premiums and decreases coverage,” the prosecution said. The resulting loss will be borne by the customer. Otherwise, patients could get treatment at a lower cost. \u2019<\/p>\n
Police, who began investigating in 2022 before prosecutors filed charges, did not charge some suspects in the case. At the time, the police said the case was a simple insurance fraud. <\/p>\n
In response, the prosecution requested a supplementary investigation but the supplementary investigation was denied by the police due to lack of evidence. During the police investigation, there were repeated attempts to hide mobile phones and tamper with evidence. <\/p>\n
The prosecution has also found that during the police investigation, ‘B’, who is considered to be the head of the hospital, actually opened and ran the dental clinic as a non-medical person. Since then, the prosecution has charged B and others with violating medical laws. “We obtained additional transcripts in March and identified the case through thorough re-investigation, including forensic data analysis,” a government official said. \u2014Agency<\/p>\n","protected":false},"excerpt":{"rendered":"
Kathmandu. Millions of dollars in dental insurance have been swindled in South Korea. More than 200 members of a large-scale organized insurance fraud group have been prosecuted for their alleged involvement in fraud. On June 31, the Seoul South District Prosecutor’s Office charged 200 people, including two dentists, two hospital directors, a consulting director and […]<\/p>\n","protected":false},"author":16,"featured_media":284375,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[45031,45044,45159],"tags":[],"class_list":["post-309289","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-banner-news-en","category-international-news-en","category-news-en"],"acf":[],"_links":{"self":[{"href":"https:\/\/english.insurancekhabar.com\/ikbrapi\/wp\/v2\/posts\/309289","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/english.insurancekhabar.com\/ikbrapi\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/english.insurancekhabar.com\/ikbrapi\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/english.insurancekhabar.com\/ikbrapi\/wp\/v2\/users\/16"}],"replies":[{"embeddable":true,"href":"https:\/\/english.insurancekhabar.com\/ikbrapi\/wp\/v2\/comments?post=309289"}],"version-history":[{"count":1,"href":"https:\/\/english.insurancekhabar.com\/ikbrapi\/wp\/v2\/posts\/309289\/revisions"}],"predecessor-version":[{"id":309290,"href":"https:\/\/english.insurancekhabar.com\/ikbrapi\/wp\/v2\/posts\/309289\/revisions\/309290"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/english.insurancekhabar.com\/ikbrapi\/wp\/v2\/media\/284375"}],"wp:attachment":[{"href":"https:\/\/english.insurancekhabar.com\/ikbrapi\/wp\/v2\/media?parent=309289"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/english.insurancekhabar.com\/ikbrapi\/wp\/v2\/categories?post=309289"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/english.insurancekhabar.com\/ikbrapi\/wp\/v2\/tags?post=309289"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}