“The implant cost 4 million won, but I received 9 million won back”… ‘Plucking the wool’ Chinese people’s actual cost insurance fraud

 As the problem of insurance fraud is becoming more serious, it has been pointed out that even foreigners are recently engaging in ‘medical shopping’, targeting the blind spots of domestic insurance. In particular, there is criticism that Chinese people, who make up the majority of foreign insurance subscribers, are abusing actual cost insurance and dental insurance. Koreans pay the insurance premiums, but Chinese people are reaping the benefits. According to the insurance industry, recently, Chinese social networking services ( SNS

) such as Xiaohongshu and Weibo have been ‘pulling wool’ regarding public and private insurance such as Korean national insurance (health insurance), actual loss insurance, and dental insurance. There are many reviews saying that . ‘Haoyangmao’ is a new word meaning ‘getting your money’. In a post posted in January of this year, a Xiaohongshu subscriber said, “I signed up for two dental insurance policies because a Korean dentist told me I needed implants.” He continued, “I had the implant surgery done after 3 months as per the regulations, and it cost about 4 million won, but I was not able to claim the insurance money. “I got back close to 9 million won,” he wrote. This post, which received nearly 100 likes, had comments from Chinese people requesting related insurance information. Another Xiaohongshu subscriber said in April this year, “I had a toothache, so I looked into Xiaohongshu and found out about Korean dental insurance. “I was skeptical and signed up for insurance and received treatment, but I received about 1 million won in insurance money,” he wrote about his experience with prosthetic treatment. He said, “I regret only signing up for dental insurance. He was advising everyone to sign up for dental insurance before going to the dentist.

In addition, you can easily find reviews of insurance claims, such as “I received so much insurance money that it could be said to be an implant investment,” and “I can get compensation for the cost of MRI scans and manual therapy by signing up for actual loss insurance and paying only about 7,000 won per month.” I was able to. There were also quite a few posts sharing photos and videos capturing the process of claiming actual loss insurance through a mobile app, as well as posts informing hospitals that can process insurance. In some cases, hospitals or hospital coordinators created accounts and posted promotional posts themselves. In this way , it is pointed out that methods of using Korean insurance are being actively shared

among Chinese people through social media , etc., causing a deficit in domestic insurance. This is because not only health insurance, but also actual cost insurance continues to be in deficit due to Chinese subscribers.

As of the end of last year, the four largest non-life insurance companies in Korea had 268,635 foreigners subscribed to actual loss insurance, and 193,015 Chinese subscribers accounted for 71.9% of the total. The risk loss ratio for Chinese nationals subscribed by these insurance companies was 117.7%, which was higher than the loss ratio for all foreign nationals subscribed (110.7%). If the risk loss ratio exceeds 100%, it means that more money was taken out as insurance money than the insurance premium paid by the subscriber.

What is worth noting is that the loss ratios of Chinese nationals in all four companies significantly exceeded the loss ratios of other nationalities excluding Chinese. The difference in loss ratio between Chinese and other nationalities is increasing every year, reaching 24.7% points in 2020, 26.2% points in 2021, and 30.3% points in 2022.

The same goes for health insurance. According to data received from the National Health Insurance Corporation by the office of Rep. Nam In-soon, a member of the National Assembly Health and Welfare Committee, last year, among all foreigners, including overseas Koreans, only Chinese people suffered a deficit of 22.9 billion won because they received more benefits than insurance premiums.

Concerns about Chinese people free-riding on health insurance led to legislative movements in the political world. Rep. Song Eon-seok and Rep. Joo Ho-young of 메이저사이트the People Power Party aim to strengthen the health insurance application requirements for dependents to a period of stay of more than 6 months in the country so that foreigners staying in Korea in 2021 cannot register their family members living abroad as dependents and only receive health insurance benefits. each proposed amendments to the National Health Insurance Act. The Ministry of Health and Welfare is also seeking to strengthen the requirements for dependents of foreign workers.

However, there is some caution in the insurance industry regarding the ‘rip-off’ controversy. It is argued that the priority is to improve related systems, including fixing lax membership requirements that may encourage foreigners to engage in medical shopping. In fact, most insurance companies currently accept insurance from foreigners as long as they have an alien registration card issued when their stay in the country is more than three months. In addition, it is difficult to properly verify even if the notification obligation is violated because the past medical history is not properly disclosed to the insurance company when signing up.

Although the loss rate for Chinese subscribers to actual cost insurance is high, some point out that there is no need to shrink the market by raising hurdles in advance as the proportion of total subscribers is still only around 1%. The insurance industry predicts that the insurance market for foreigners will also grow in the future as demand for foreign immigration is expected to increase in preparation for the decline in the domestic working-age population.

An industry official said, “Chinese subscribers are giving tips on using Korean insurance.“It is true that the loss ratio is worse compared to other nationalities as they share it on social media and make a lot of insurance claims and receipts,” he said. “But since their share of the total actual loss insurance is not yet large, insurance companies are showing a cautious attitude, saying they will wait and see for now. ” “It appears that this is a situation that requires further discussion,” he said.

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