Inflated health insurance claims recorded ₩650 bil. in 2019 < Policy < 기사본문 – KBR – KBR

Inflated health insurance claims by patients who had only minor injuries in traffic accidents recorded 650 billion won ($532 million) in 2019, government data showed.

On Sunday, the Korea Insurance Research Institute (KIRI) released a report saying false health insurance claims reached 111.5 billion won in 2019 among claims by patients with Grade 12/14 mild injuries.

Inflated health insurance claims by patients who had minor injuries in traffic accidents recorded 650 billion won in 2019, government data showed.

The institute said that exaggerated insurance claims by mild injury patients recorded 535.3 billion won. These inflated treatment costs are differences between car insurance medical expenses for mild injury patients and health insurance costs for mild injury patients.

Health insurance costs were calculated by multiplying the number of days of treatment for patients with health insurance for spinal sprains and mild bruises of the extremities, which are frequent injuries for automobile insurance patients, by the medical expenses for automobile insurance patients with mild injuries.

The institute said that false health insurance claims and inflated health insurance claims accounted for 11.1 percent and 53.5 percent of the total car insurance claims by patients with mild injuries.

In other words, 64.6 percent of the car insurance claims by patients with mild injuries were caused by excessive treatment in 2019. If the 646.8 billion won inflated insurance claims are divided by per-capita health insurance premiums, it translates into 31,200 won per person.

Jeon Yong-sik, a senior research fellow at KIRI, predicted that insurance premiums for personal injury compensation would increase rapidly due to the Covid-19 pandemic and rising inflation caused by Russia’s invasion of Ukraine.

“Higher unemployment rates and rising consumer prices push up the cost of maintaining a vehicle, so people seem to have a bigger desire for compensation in an accident,” Jeon said. “The instability in the global economy is likely to persist, and this will have a negative impact.”

The nation needs an improvement in the compensation system to curb the upward trend of health insurance premiums, pushed up by increases in insurance payments and overtreatment, he went on to say.

Also, he added that the government has to discover problems in the auto insurance system that induces excessive treatment for patients with mild injuries.