Some hospitals that induced cataract surgery in this way, fraudulent insurance and tax evasion were caught. Cataract is one of the main culprits in loss of life insurance. More than 1 trillion won a year is withdrawn from indemnity insurance in the name of cataract surgery costs, and good subscribers suffer damage as they bear the burden of insurance premiums.
An insurance company that failed to see has reported 16 hospitals suspected of fraud and tax evasion to the National Tax Service. According to the insurance industry on the 13th, domestic insurance company A reported to the National Tax Service to investigate the non-issuance of cash receipts and issuance of false receipts, saying that 16 hospitals were suspected of insurance fraud and tax evasion related to cataract surgery costs.
An insurance company official said, “When we analyzed the hospitals that claim cataract surgery insurance, certain hospitals, which account for only 7.2% of the total, accounted for 46% of the total number of payments and 70% of the insurance payments.” The official also said, “The act of some hospitals that induces patients to participate in insurance fraud is not only false and excessive treatment for cataracts, but also promotes insurance fraud and deceives good hospitals and the public. “he emphasized. The average medical cost related to cataract surgery at these hospitals was around 9 million won per case.
A new method was also discovered. Some subscribers paid the cost of cataract surgery, which resulted in a high uninsured amount of more than 10 million won while performing surgery at these hospitals, by using a credit card, and then made a claim to the insurance company and received the payment. Afterwards, it was found that they canceled the card payment and used a method of paying less in cash than the amount issued by the existing receipt. After confirming this fact, insurance company A reported 16 hospitals suspected of tax evasion to the National Tax Service, and additional confirmation of 10 hospitals is underway.
The National Tax Service plans to begin a tax investigation on hospitals with tax evasion circumstances after reviewing the report. According to the Korea Insurance Research Institute, the proportion of cataract surgery in total indemnity insurance premiums increased 4.8 times over the past four years, from 1.4% in 2016 to 6.8% in 2020. The industry believes that the insurance premium for cataract surgery increased rapidly from 77.9 billion won in 2016 and exceeded 1 trillion won last year.
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