Workers' Compensation Insurance Fraud Is Not Something You Can Take Lightly
What Does Workers' Compensation Insurance Fraud Mean Legally?
Workers' compensation insurance fraud refers to falsely reporting an accident or illness that does not actually qualify as an industrial accident as if it were one, or misrepresenting the circumstances of the accident, work arrangement, or average wage, in order to wrongfully obtain workers' compensation benefits or premium advantages.
- Constitutes unlawful receipt of benefits under the Industrial Accident Compensation Insurance Act, subject to recovery of the wrongfully received amount as well as an additional surcharge
- If a falsified medical certificate or fabricated accident circumstances are confirmed, charges of fraud and forgery of private documents under the Criminal Act may also apply
- In many cases where the employer is involved, the employer is punished together with the employee as a co-principal
As such, workers' compensation insurance fraud is not a mere administrative violation but a serious crime that can lead to criminal punishment, and this must be kept firmly in mind.
From Detection to Trial: What Is the Process?
Once suspicion of workers' compensation insurance fraud arises, the case generally proceeds through the following stages.
- Report and internal investigation
The Korea Workers' Compensation & Welfare Service detects signs of irregularity and launches an investigation - On-site verification and document request
Medical records, work records, CCTV footage, and other objective evidence are cross-checked - Referral to investigative authorities
If clear evidence of fraudulent receipt is found, the case is referred to the police or prosecution - Suspect investigation and referral
After questioning those involved, the case is transferred to the prosecution - Indictment and trial
Sentences range from fines to actual imprisonment
Because the direction of the initial statement and the preparation of supporting evidence largely determine the final outcome, it is critical to seek professional assistance as soon as you receive notice of an investigation related to workers' compensation insurance fraud.
A Real Case of Workers' Compensation Insurance Fraud
[Case We Handled]
Mr. B, who ran a manufacturing company, falsified documents to make an employee's personal injury appear to be a work-related accident and applied for workers' compensation benefits, but the truth came to light during a verification investigation by the Korea Workers' Compensation & Welfare Service, leading to his being reported to the authorities.
From the early stages of the investigation, Mr. B worked with Decent Law Firm to organize the facts and actively demonstrate his willingness to voluntarily return the benefits, ultimately resolving the case with a small fine.
As shown, the outcome of a workers' compensation insurance fraud case can vary greatly depending on how it is handled in the early stages.
The Role of Defense Counsel, and Why You Should Work With Decent
Workers' compensation insurance fraud cases require professional handling in the following respects.
- Legal review of the Korea Workers' Compensation & Welfare Service's investigation materials
- Securing the right of defense during questioning and establishing a response strategy
- A comprehensive response that takes into account both recovery/additional surcharges and criminal punishment
Based on extensive experience handling criminal cases related to industrial accidents and insurance, Decent carefully reviews each client's situation and builds a systematic defense strategy from the early stages of the investigation through trial.
Workers' compensation insurance fraud is a type of case in which securing supporting evidence becomes increasingly difficult the longer you wait.
If you have already received notice of an investigation or are troubled by related facts, we recommend consulting first with defense counsel experienced in labor and criminal cases rather than deciding on your own.
Decent Law Firm is always ready to provide prompt and accurate legal consultation to help you find the best direction for your situation.
