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Fraudulent health insurance claims by foreigners rise after 2-year decline

Published: 04 May. 2025, 16:36 Updated: 04 May. 2025, 18:38

The National Health Insurance Service Mapo Branch in Mapo District, western Seoul [NEWS1]

Fraudulent health insurance claims by foreign nationals and overseas Koreans increased sharply in 2024, reversing a two-year decline. The amount involved in these claims rose nearly 30 percent.

Lawmaker Kim Mi-ae of the People Power Party, who sits on the National Assembly’s Health and Welfare Committee, released data on Sunday from the National Health Insurance Service (NHIS), showing that authorities uncovered 17,087 individuals involved in fraudulent claims in 2024, up 16.8 percent from 14,630 in 2023.

The number of individuals caught had dropped for two consecutive years — from 40,265 in 2021 to 18,491 in 2022 and 14,630 in 2023 — before rising again last year. The number of fraudulent cases and the total amount of illegitimate claims also increased.

Authorities reported 45,909 cases of fraud in 2024, a 14.7 percent increase from 40,020 cases in 2023. The total amount of fraud reached 2.56 billion won ($1.82 million) in 2024, up 28.5 percent from the previous year.

Most of the fraud involved individuals who continued to use health insurance benefits after losing their eligibility.

Authorities identified 17,011 individuals in this category in 2024. These cases totaled 44,943 incidents, amounting to 2.506 billion won.

Officials also caught 41 people borrowing or misusing someone else’s health insurance card. These cases involved 845 claims, totaling 47 million won.

Authorities also found 35 individuals who used insurance benefits during periods when their coverage was suspended. These cases involved 121 claims totaling 5 million won.

Among those caught, Chinese nationals accounted for the majority at 12,033 people, or roughly 70 percent. U.S. nationals followed with 679 cases and Vietnamese nationals at 605.

“Fraudulent claims by some foreign nationals severely undermine the financial health of the national health insurance system and threaten its sustainability,” Lawmaker Kim said. “The government must strengthen penalties for offenders and consider adopting reciprocal agreements in insurance coverage while pursuing comprehensive reforms.”

Translated from the JoongAng Ilbo using generative AI and edited by Korea JoongAng Daily staff.
BY CHAE HYE-SEON [[email protected]]