An Example Involving a Gwangju Attorney | A Client Represented by a Gwangju Attorney Concludes a Substantial Insurance Fraud Charge with Only a Minor Fine

The client came to a Gwangju attorney due to a charge of 🔗insurance fraud.

The Daeryun Gwangju attorney will explain what insurance fraud is and the relevant statutes.

An act of insurance fraud means the act of claiming insurance proceeds by deceiving the insurer as to the occurrence, cause, or content of an insured event.

As for the punishment of those who commit insurance fraud, the Special Act on Prevention of Insurance Fraud applies in priority to other statutes.

In addition, if a judgment of a fine or more is rendered, then, separately from the criminal punishment, the full amount of the wrongfully paid insurance proceeds, calculated with interest, is recovered.

Special Act on Prevention of Insurance Fraud, Article 8 (Insurance Fraud)

① A person falling under any of the following shall be punished by imprisonment for not more than 10 years or by a fine not exceeding 50 million won.

1. A person who, by an act of insurance fraud, acquires insurance proceeds or causes a third party to acquire insurance proceeds

2. A person who, in violation of Article 5-2, arranges, induces, solicits, or advertises an act of insurance fraud

② In the case of paragraph (1), item 1, a sentence of imprisonment and a fine may be imposed concurrently.

For the client who came to a Gwangju attorney, Daeryun demonstrated that the client had not received the insurance proceeds on the basis of false facts.

In fact, the client had received manual therapy and other treatment on dozens of occasions or more.

In the course of claiming the insurance proceeds, the client believed the hospital's statement that it would handle the paperwork on his behalf and did not pay particular attention to the matter.

The client had been entirely unaware that the hospital was defrauding the insurer of insurance proceeds by falsely reporting additional treatment beyond the treatment the client had received.

The client who came to a Gwangju attorney submitted, as evidence, the payment records for the treatment the client had actually received.

The Gwangju attorney argued that the client had in fact received treatment and had consistently stated, from the early stage of the investigation, that he had received treatment.

Daeryun emphasized that, apart from the hospital's false report of additional treatment, the treatment the client himself received, the card payment records, and the medical care benefit records were consistent with one another.