Presidential Decree No. 27532, Sep. 29, 2016
Article 1 (Purpose) |
Article 2 (Reporting, etc. on Insurance Fraud) |
1. | Name of the relevant insurance company; |
2. | Date and place of conduct to be reported; |
3. | Persons related to conduct to be reported; |
4. | Details of conduct to be reported. |
Article 3 (Delay in Payment of Insurance Money and other Grounds) |
1. | Where the terms and conditions of the relevant insurance contract or other statues prescribe that the payment of insurance money shall be delayed or rejected, or the amount of insurance money shall be reduced; |
2. | Where justifiable grounds exists to suspect that any of the following conduct committed by a policy holder, etc. prescribed in Article 4 of the Act, constitutes insurance fraud, in the course of an insurance company investigating insurance incident. In such cases, it shall be limited to where the payment of insurance money is delayed: |
a. | Where it is reported to the Financial Services Commission pursuant to Article 4 of the Act; |
b. | Where a report or a request for investigation is made to the competent investigative agency or other necessary measures are taken pursuant to Article 6 of the Act. |
3. | Where an insurance company is found to have committed any of the following conduct in relation to outcomes of investigations of insurance accidents: |
a. | Where a complaint is filed; |
b. | Where a request for dispute conciliation is made pursuant to the Judicial Conciliation of Civil Disputes Act or the Act on the Establishment, etc. of Financial Services Commission. |
4. | Other cases prescribed and publicly announced by the Financial Services Commission, where a resonable ground exists for an insurance company to delay or refuse the payment of insurance money, or to reduce the amount of insurance money. |
Article 4 (Entrustment of Affairs) |
Article 5 (Handling Sensitive Information and Personally Identifiable Information) |
1. | Affairs involving receipt of reports prescribed in Article 4 of the Act; |
2. | Affairs on measures, such as accusation prescribed in Article 6 (1) of the Act; |
3. | Affairs on reviewing the propriety of hospitalization pursuant to Article 7 (2) of the Act. |
Article 6 (Standards for Imposition of Fines for Negligence) |