Falsified Work Hours by Carrying Door; Court Rules Recovery of Benefits Is Justified

Caregiver Registered False Work Hours by Carrying Check-In Tag
Inflated Work Hours Without Visits... 37.4 Million Won to Be Recovered

The court has ruled that the decision by the National Health Insurance Service (NHIS) to recover long-term care benefits paid to a caregiver who falsified work hours by carrying the check-in tag in the vehicle is lawful.

According to Yonhap News Agency on July 19, quoting legal sources, the Seoul Administrative Court, Administrative Division 5 (Presiding Judge Lee Jeongwon), recently ruled against a senior long-term care institution that filed a lawsuit seeking to cancel the NHIS’s disposition ordering the return of long-term care benefit payments.

Caregiver A, affiliated with the institution, registered the end of work hours near her own home and other locations even when she had not actually provided services, thereby inflating work hours and submitting claims for long-term care benefits based on these false records.

For home-visit care services, check-in and check-out are supposed to be recorded by tapping a mobile phone on the tag provided at the beneficiary's home. However, A registered the end of work hours near her home and other locations, even without providing actual services, in order to exaggerate work hours, and claimed long-term care benefits based on these records.

Yonhap News Agency

It was found that from 2021 to 2023, A removed the entrance cabinet door at the beneficiary’s home where the check-in verification tag (a wireless communication device) was installed, carried it in her vehicle, and used it in this way.

In November 2023, the NHIS conducted an on-site investigation and notified the institution that it would recover approximately 37.4 million won, stating that long-term care benefits had been unjustly claimed. During the investigation, A reportedly acknowledged in a written statement that she had falsely recorded work hours and submitted claims based on these falsified records.

In response, the long-term care institution argued that the tag was only separated in order to record the end time when going out with the beneficiary, insisting that there had been no false work registration, and filed a lawsuit demanding the cancellation of the recovery disposition.

However, the court sided with the NHIS, citing that A admitted to making false claims during the investigation, and that most of the work end records were made near A’s home.

The court also referred to the Ministry of Health and Welfare’s notice on long-term care benefit provision standards, stating, “Home-visit benefits must in principle be provided at the beneficiary’s home, and outings, travel, and accompanying for hobbies do not fall under this category.”

Accordingly, the court did not recognize outings with beneficiaries as home-visit care services and rejected the plaintiff’s claim.

This content was produced with the assistance of AI translation services.