• The Korean Society of Law and Medicine
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• v.14 no.2
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• pp.11-41
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• 2013

Article 347 of criminal law provides the act of deceiving another, thereby taking property or obtaining pecuniary advantage from another. On the other hand, the concepts of fraud and abuse are confused upon interpretation since the definition in National Healthcare Insurance Law is unclear, and it affects closely to the administrative measures such as surcharge levy by the period of inspection, therefore, the disputes continue in the forms of formal objection, administrative ruling and administrative litigation. This study aims to look over the legal problems on application of criminal fraud toward the abuse of 'Paid Medical Expenses(Article 57, Sections 1 and 4 of the National Health Insurance Act)'. The main issues are concept of abuse(Article 57, Sections 1 and 4 of the National Health Insurance Act), the problems of Directions of Health-Welfare Ministry on aspect of 'Nullum crimen sine lege' Principles, the proper sentenc-ing guidelines of fraud.

• International Journal of Contents
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• v.8 no.2
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• pp.82-88
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• 2012

Fraud and corruption is a problem that undermines the credibility and integrity of all sport. It affects fans, owners, shareholders, officials, and players. With the recent scandal in the K-League in Korea, the importance of maintaining the integrity of Korean football is presently of great importance. While other European or Asian football leagues have been plagued with fraud and corruption, Korea has maintained its professional sporting integrity successfully until recent times. This paper is an examination as to why players in the K-League succumbed to match- fixing in 2011. Firstly, we discuss the important role of sport in Korea, which is not to be underestimated. Secondly, we briefly illustrate the range and types of fraud and corruption in international football. Thirdly, we focus on the match-fixing and gambling scandal currently engulfing the K-League. Fourthly, we make some practical suggestions on how to combat and increase resilience to fraud and corruption in football. Finally, in the conclusion, we suggest that much needs to be done to reduce the incident of fraud and corruption in football worldwide, particularly through employing a clear counter fraud strategy.

• Information Systems Review
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• v.5 no.1
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• pp.49-60
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• 2003

The purpose of this study is to empirically and practically verify the applicability of visualization data mining tool in detecting real-word insurance frauds that are now emerged as one of the most serious problems socially and economically. For the verification, Analyst's Notebook by i2, which has been known as the most effective visualization data mining tool, was adopted. With Analyst's Notebook, fraud-probable insurance transactions from a very large insurance claims are selected and then substantiation for insurance frauds are attempted. The results show that Analyst's Notebook not only detects insurance fraud transactions from a vast number of insurance claims, but is also able to pinpoint organized crime group by associating one fraud transaction to another fraud transaction. Therefore, it is safe to conclude that visualization data mining is very effective in detecting false transactions and crime behaviors including insurance fraud.

• THE INTERNATIONAL COMMERCE & LAW REVIEW
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• v.49
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• pp.139-164
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• 2011

Traditionally courts have been adopted over the years two standards of dealing with compliance of documents such as strict compliance and substantial compliance and the substantial compliance, which was somewhat less demanding than the strict compliance. However the new guidelines of ICC's international standard banking practice for the examination of documents under documentary credits set up how the UCP is to be applied in practice. The payment obligations of an issuing bank to a beneficiary are independence of the performance or the nonperformance of any contract underlying the letter of credit. However, strictly applying the principle of independence and abstraction could produce unfair results by operating unjustly enrich an unscrupulous beneficiary in case of fraud. Accordingly, when a beneficiary presents complying documents, the issuing bank is bound to honour the presentation unless the fraud rule applies on the facts of the case such as forged or material fraud. If it does, the issuing bank(issuer) needs not pay despite the complying presentation of documents by the beneficiary under the Uniform Commercial Code Article 5-109 and case law in America. However the fraud rule was not addressed in UCP 600. In conclusion, view in terms of legal principle and the court cases is variable and difficult to honour or dishonour the presentation in case of application of the independence principle and fraud rule such as the problems on burden of proof timely, possibility of granting injunction in order to protect against victim for bona fide applicant.

• Journal of the Korea Society of Computer and Information
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• v.24 no.1
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• pp.207-215
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• 2019

The insurance system is indispensable to our society. However in recent years, there have been a lot of insurance fraud crimes, such as the abuse of these valuable insurance system and the cheating the insurance proceeds. These insurance frauds make the insurance companies harder to manage, and as a result, the insurance premiums have risen, which has caused a lot of damaging good policyholders. However, the damage caused by insurance fraud has been continuously increasing due to the punishment of cotton stick. Therefore, after the long discussion, the 'The Act for Prevention of Insurance Fraud', which is a special law recently has been enacted. However, within two years of the enactment of this law, which was enacted after much anticipation and long waiting, there is already debate about its effectiveness. The reason for this is that even though the law was enacted and enforced, insurance fraud continues to increase and even punishment for these crimes is not strengthened, and now it is time to look for specific problems and resolutions for these crimes see. So in this paper the author dealt with the problems of the law, first, related regulation of insurance payment, second, right to terminate insurance contract and return of insurance proceeds, third, regulation on notification of investigations, fourth, regulations on the adequacy of hospitalization. Of course, since this law has just been enacted, there are many other problems besides these problems, but I tried to present a fresh resolution based on the problems that have been mainly discussed since the legislative period.

• International Journal of Computer Science & Network Security
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• v.21 no.9
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• pp.31-40
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• 2021

The increasing number of credit card fraud cases has become a considerable problem since the past decades. This phenomenon is due to the expansion of new technologies, including the increased popularity and volume of online banking transactions and e-commerce. In order to address the problem of credit card fraud detection, a rule-based approach has been widely utilized to detect and guard against fraudulent activities. However, it requires huge computational power and high complexity in defining and building the rule base for pattern matching, in order to precisely identifying the fraud patterns. In addition, it does not come with intelligence and ability in predicting or analysing transaction data in looking for new fraud patterns and strategies. As such, Data Mining and Machine Learning algorithms are proposed to overcome the shortcomings in this paper. The aim of this paper is to highlight the important techniques and methodologies that are employed in fraud detection, while at the same time focusing on the existing literature. Methods such as Artificial Neural Networks (ANNs), Support Vector Machines (SVMs), naïve Bayesian, k-Nearest Neighbour (k-NN), Decision Tree and Frequent Pattern Mining algorithms are reviewed and evaluated for their performance in detecting fraudulent transaction.

• Journal of Digital Convergence
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• v.20 no.3
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• pp.35-40
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• 2022

With the advent of the internet age and the outbreak of COVID-19, many companies have embraced online trade. However, due to the way the cyber economy works, the number of companies engaged in financial fraud by falsifying their transaction amounts and customer numbers has been gradually increasing. The purpose of this study is to analyze financial fraud of companies in the Internet era and to present solutions. Therefore, this study analyzed the financial fraud behavior of Luckin Coffee in China as an example and studied the causes and countermeasures of financial fraud. As a result, it was found that the cause of financial fraud lies in the opacity of cash flows from online transactions. The recommendations proposed by this study is to improve internal control systems in companies, develop risk management system, and establish comprehensive external supervision system

• Journal of Legislation Research
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• no.53
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• pp.553-591
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• 2017

This article discussed whether so-called 'foreign judgments obtained by fraud' is in breach of public policy provided in Article 217(1)(3) of Civil Procedure Act and, if so, what the specific requirements could be. The summary of the conclusion is as follows. The 'foreign judgments obtained by fraud' is against the municipal procedural public policy and then shall not be recognized. In this regard one more question comes up whether reviewing if 'foreign judgments obtained by fraud' is in breach of the municipal procedural public policy is allowed in consideration of the principle of prohibition of $r{\acute{e}}vision$ au fond. Since the principle is applied entirely in the course of the above reviewing, it is allowed only when it does not breach the principle. The two instances that the reviewing is allowed are where the defendant was not able to produce evidences of fraud during foreign procedures and where the defendant's claim of fraud without evidences was rejected by the foreign court and then evidences of fraud were found after the foreign procedure was completed. On the other hand, the specific requirements for 'foreign judgments obtained by fraud' to be against public policy are following four requirements based on principle of strict interpretation of public policy. (1) plaintiff's intention to fraud, (2) preventing the defendant from being involved in the procedure by fraud or cheating the foreign court using manipulated evidences, (3) the defendant could not present himself in the foreign court procedure due to the plaintiff's extraneous fraud or the foreign court decided wrongly due to intrinsic fraud, and (4) defendant's fundamental procedural rights were breached to the extent that recognizing the effect of foreign judgments was against justice defendant's fundamental procedural rights. These results differ from the Supreme Court 2004. 10. 28. ruling 2002da74213 in many aspects. Most of all, in my opinion there is no need to distinguish between intrinsic fraud and extraneous fraud and reviewing 'foreign judgments obtained by fraud' is not in conflict with the principle of prohibition of $r{\acute{e}}vision$ au fond but the both may coexist. In this regard I expect the variation of the Supreme Court's position and hope to contribute to academia and practitioners.

• Journal of the Korea Society of Computer and Information
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• v.25 no.3
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• pp.117-127
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• 2020

Recently, proving insurance fraud has become increasingly difficult because it occurs intentionally and secretly via organized and intelligent conspiracy by specialists such as medical personnel, maintenance companies, insurance planners, and insurance subscribers. In the case of car accidents, it is difficult to prove intentions; in particular, an insurance company with no investigation rights has practical limitations in proving the suspicions. This paper aims reveal that the detection of organized and conspired insurance fraud, which had previously been difficult, could be dramatically improved through conspiring insurance fraud detection modeling using social network analysis and visualization of the relation between suspected group entities and by seeking developmental research possibilities of data analysis techniques.

• Journal of the Korea Institute of Information Security & Cryptology
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• v.25 no.6
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• pp.1525-1540
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• 2015

Due to a rapid advancement in the electronic commerce technology, the payment method varies from cash to electronic settlement such as credit card, mobile payment and mobile application card. Therefore, financial fraud is increasing notably for a purpose of personal gain. In response, financial companies are building the FDS (Fraud Detection System) to protect consumers from fraudulent transactions. The one of the goals of FDS is identifying the fraudulent transaction with high accuracy by analyzing transaction data and personal information in real-time. Data mining techniques are providing great aid in financial accounting fraud detection, so it have been applied most extensively to provide primary solutions to the problems. In this paper, we try to provide an overview of the research on data mining based fraud detection. Also, we classify researches under few criteria such as data set, data mining algorithm and viewpoint of research.