Doctors and brokers caught in cosmetic treatment insurance fraud

입력 2024.11.20 (00:03)

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[Anchor]

Doctors and brokers who deceived patients into undergoing cosmetic surgeries and beauty treatments that cannot receive insurance payouts, and then embezzled billions of won by falsely claiming these as non-covered treatments, have been caught by the police.

The police believe that they organized an insurance fraud scheme and have applied charges of organized crime for the first time against medical institutions.

Kim Arnae reports.

[Report]

Police officers stormed a dermatology clinic in Busan.

They showed a warrant to the director and explained the criminal charges.

They were caught after providing patients with cosmetic surgeries or beauty treatments and helping them claim insurance payouts.

[Police Official: "This hospital provided cosmetic treatments...."]

They manipulated medical records to make it appear as if patients received non-covered treatments like physical therapy or stem cell procedures.

From 2020 until last April, they embezzled a total of 6.4 billion won in insurance payouts.

Patients received insurance money, while the hospital kept about 10-20% of the treatment costs.

[Insurance Company Official/Voice Altered: "(The documents are) fabricated, so the insurance company cannot determine whether this claim is false or true based solely on those documents."]

In an unusual move, the police applied organized crime charges to the hospital director and seven brokers.

They established the clinic for the purpose of insurance fraud and even employed loss adjusters to guide patients on the scheme, indicating a systematic approach to their crimes.

They also demonstrated meticulousness by hiding 200,000 medical records in a warehouse far from the clinic.

[Choi Haeyoung/Team Leader of the Criminal Investigation Unit 1, Busan Metropolitan Police Agency: "They had loss adjusters or assistants stationed there, solely resolving insurance issues. And they were paid monthly... This was very organized and systematic...."]

Four individuals, including the director and clinic staff, have been arrested and indicted, while over 750 patients have been sent to the prosecution without detention on charges of insurance fraud.

KBS News, Kim Arnae.

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  • Doctors and brokers caught in cosmetic treatment insurance fraud
    • 입력 2024-11-20 00:03:10
    News 9
[Anchor]

Doctors and brokers who deceived patients into undergoing cosmetic surgeries and beauty treatments that cannot receive insurance payouts, and then embezzled billions of won by falsely claiming these as non-covered treatments, have been caught by the police.

The police believe that they organized an insurance fraud scheme and have applied charges of organized crime for the first time against medical institutions.

Kim Arnae reports.

[Report]

Police officers stormed a dermatology clinic in Busan.

They showed a warrant to the director and explained the criminal charges.

They were caught after providing patients with cosmetic surgeries or beauty treatments and helping them claim insurance payouts.

[Police Official: "This hospital provided cosmetic treatments...."]

They manipulated medical records to make it appear as if patients received non-covered treatments like physical therapy or stem cell procedures.

From 2020 until last April, they embezzled a total of 6.4 billion won in insurance payouts.

Patients received insurance money, while the hospital kept about 10-20% of the treatment costs.

[Insurance Company Official/Voice Altered: "(The documents are) fabricated, so the insurance company cannot determine whether this claim is false or true based solely on those documents."]

In an unusual move, the police applied organized crime charges to the hospital director and seven brokers.

They established the clinic for the purpose of insurance fraud and even employed loss adjusters to guide patients on the scheme, indicating a systematic approach to their crimes.

They also demonstrated meticulousness by hiding 200,000 medical records in a warehouse far from the clinic.

[Choi Haeyoung/Team Leader of the Criminal Investigation Unit 1, Busan Metropolitan Police Agency: "They had loss adjusters or assistants stationed there, solely resolving insurance issues. And they were paid monthly... This was very organized and systematic...."]

Four individuals, including the director and clinic staff, have been arrested and indicted, while over 750 patients have been sent to the prosecution without detention on charges of insurance fraud.

KBS News, Kim Arnae.

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