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Legal Issues and Future Tasks of the Special Act on Prevention of Insurance Fraud

  • Legal Theory & Practice Review
  • Abbr : LTPR
  • 2022, 10(4), pp.171-204
  • Publisher : The Korea Society for Legal Theory and Practice Inc.
  • Research Area : Social Science > Law
  • Received : November 4, 2022
  • Accepted : November 21, 2022
  • Published : November 30, 2022

Youngkook Kim 1

1국회입법조사처

Accredited

ABSTRACT

In order to reduce and prevent insurance fraud crimes, the Special Act on Insurance Fraud Prevention (hereinafter the “Special Act”) was enacted and enforced on September 30, 2016. From the point of view of the establishment of an insurance fraud prevention system, a special insurance fraud investigation team was established in insurance companies and an organic relationship was established between the Financial Supervisory Service, the Financial Services Commission, and the investigation agency, so that a structure to respond to insurance fraud was created. However, it is difficult to give a clear answer in terms of its effectiveness, such as whether insurance fraud crimes have actually decreased due to the enforcement of the special law. Rather, it is pointed out that the special law narrowed the scope of insurance fraud crimes, and there is also the problem of exaggerating accidents and exaggerating the limits of soft fraud to receive insurance money. In relation to health insurance, which is a public insurance, there is also the issue of delays in investigations in relation to the eligibility review for hospitalization. Although the final judgment has been made for an insurance fraud crime and insurance money has to be recovered, the related legal system such as the statute of limitations does not fit into the changing environment, resulting in a situation that benefits criminals. Various efforts have been made to raise awareness about insurance fraud and to detect it, but in proportion to this, insurance fraud crimes are also intelligently organized and organized, avoiding the legal network of the special law, raising doubts in terms of effectiveness. Despite the discussion that the punishment of insurance fraud crimes should be strengthened, there are great difficulties in detecting and proving insurance fraud crimes. Accordingly, cooperation with related agencies should be appropriately reflected in special laws so that insurance fraud investigations and investigations can be carried out smoothly. It is necessary to reinterpret and revise the rules of justice.

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