An insurance planner surnamed B, affiliated with A Life Insurance, colluded with officials from a nursing hospital in 2016 to inflate hospital expenses on receipts. Afterward, they filed an insurance claim and received 7.73 million won from a certain insurance company.An insurance planner surnamed D, affiliated with C Non-Life Insurance, conspired with a colleague between 2015 and 2017 to intentionally cause traffic accidents, disguising them as accidental events before filing insurance claims. In reality, there were no accidents, but they pretended to be injured while getting off public transport. Through this method, they fraudulently obtained 39.49 million won from various insurance companies over two years.
As the scale of insurance fraud has increased recently, the Korean National Police Agency, Financial Supervisory Service, and other major institutions have actively implemented sanctions, prompting insurance companies to strengthen internal training for planners.
According to the FSS Insurance Fraud Response Team on the 8th, there were a total of 47 cases of sanctions against planners affiliated with life insurance and non-life insurance companies for fraudulent crimes in the first half of this year. In the same period last year, there were no sanctions imposed by the FSS Insurance Fraud Response Team on insurance planners.
The FSS Insurance Fraud Response Team reviews cases of insurance fraud where charges have been confirmed after verdicts, proceeding with sanctions only for larger-scale cases according to its internal criteria. The increase in sanctions this year indicates that larger-scale insurance frauds are gradually rising. According to the FSS, the amount of fraud detected last year was counted at 1.1502 trillion won, an increase of 33.8 billion won (3%) compared to the previous year. Sanctioned planners may have their operations suspended for 2 to 3 months or may have their planner qualifications entirely canceled.
The Korean National Police Agency is also conducting special crackdowns on insurance fraud from May to October this year. They are receiving specific materials on suspects through the FSS and swiftly carrying out investigations. An official from the FSS noted, “The frequency of planners being involved in organized crime has been increasing, so we are closely monitoring the situation,” adding, “This year, with the growing amount of crime, the number of detections is expected to rise as well.”
Major insurance companies are also implementing preventive measures. Hyundai Marine & Fire Insurance has arranged additional lectures for exclusive planners on preventing insurance fraud and promoting crime reporting, alongside regular training this year. Hanwha Life has begun analyzing the current status of improper sales and educating planners on consumer protection starting this year. Additionally, they are regularly visiting sales sites in various regions to verify handwritten applications and assess the suitability of variable insurance.
Samsung Life Insurance is strengthening its compliance organization and conducting mystery shopping at sales sites this year. Samsung Fire & Marine Insurance stated that they are providing monthly compliance training for planners and intermittently conducting mystery shopping to review the appropriateness of recruitment activities.
An official from the insurance industry said, “The planners receiving sanctions are just a small portion and do not significantly affect revenue, but it could lead to damage to brand image and contract cancellations, which is why insurance companies are paying attention.”