'Lee Chan-jin's Pledge' FSS and HIRA Establish Insurance Fraud Coordination System... "Faster Investigation Requests"

Information Sharing on Insurance Fraud and Improper Claims

Working-Level Consultative Body to Be Operated

Lee Chan-jin: "Joint Response to Indemnity Insurance Overtreatment, Strict Measures Against Automobile Fraud"

The Financial Supervisory Service (FSS) will strengthen information sharing with the Health Insurance Review and Assessment Service (HIRA), operate a working-level consultative body, and enhance its capabilities to respond to insurance fraud. As Lee Chan-jin, Governor of the FSS, has pledged, the FSS plans to take on a platform role in combating insurance fraud, intensifying cooperation with HIRA and others, with the goal of dramatically reducing insurance payout losses caused by insurance fraud and improper claims by medical institutions.

Lee Chanjin, Governor of the Financial Supervisory Service, is attending the Asset Management Company CEO Meeting held at the Korea Financial Investment Association in Yeouido, Seoul on the 13th, delivering opening remarks. 2026.07.13 Photo by Dongju Yoon

On the 16th, the FSS announced that it had signed a business agreement with HIRA to eradicate insurance fraud and improper claims by medical institutions.

With the ongoing abuse of indemnity health insurance and automobile insurance, as well as the continuous improper claims by healthcare providers, concerns have been raised that both public and private insurers are experiencing growing insurance payout losses.

In this regard, at a press conference held at the end of June, Governor Lee stated, "The FSS will serve as a universal platform for insurance fraud response and will swiftly activate its response system." He also announced plans to strengthen collaboration with organizations such as HIRA.

First, the two organizations plan to enhance information sharing in order to quickly detect insurance fraud and crimes by improper claim-submitting healthcare providers. For example, they intend to exchange cases suspected of improper billing in health and automobile insurance, as well as potential insurance fraud incidents.

An FSS official explained, "We will analyze and review claims data to identify suspected insurance fraud," adding, "Through these efforts, detection of insurance and healthcare crimes is expected to be further strengthened."

Both organizations will also use data from indemnity and automobile insurance to promptly respond to abnormal signs such as excessive medical treatment, and will strengthen monitoring of hospitals and clinics that violate fee standards. They also plan to discuss securing resources for review operations.

In addition, the two organizations will encourage the exchange of expertise and personnel regarding insurance fraud, automobile insurance reviews, and improper billing of medical benefits. Moving forward, they have also agreed to operate a practical consultative body to facilitate concrete implementation.

Governor Lee emphasized, "With today’s agreement, we will maximize synergy between the FSS and HIRA through active information sharing and joint response to abnormal signs such as excessive non-covered treatment in indemnity insurance." He added, "We will carefully investigate the likelihood of insurance fraud at medical institutions improperly claiming automobile insurance and, when suspicions arise, swiftly request thorough investigations."

HIRA President Hong Seung-kwon also said, "This agreement marks a meaningful first step toward jointly responding to illegal acts that threaten the soundness of public and private insurance, and creating a trustworthy health and financial environment for the public." He continued, "The two organizations will share information related to insurance fraud and improper claims even more closely, and will establish a robust collaborative system to prevent financial losses in both public and private insurance."

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