Boammo, One Year After Occupying Samsung Life Customer Center
Supreme Court Ruled in Favor of Samsung Life, but Financial Supervisory Service Imposes Severe Sanctions
Protests Continue Despite Assembly Ban and Eviction Orders
[Asia Economy Reporter Oh Hyung-gil] It has been a year since members of the “Cancer Patients’ Association Responding to Insurance Companies (Boammo)” occupied the Samsung Life Insurance customer center and began protesting, yet the conflict over unpaid cancer insurance hospitalization fees for long-term care hospitals remains at a standstill.
Meanwhile, the Supreme Court ruled in favor of Samsung Life Insurance in a lawsuit filed by the Boammo representative, but the Financial Supervisory Service (FSS) ignored the court’s decision that payment was not required and imposed severe sanctions on Samsung Life Insurance. Despite court orders to prohibit the assembly and vacate the premises, Boammo members have not lifted their occupation protest. Amid these conflicting judgments, no one has provided a solution, and the conflict between Samsung Life Insurance and Boammo has remained an ongoing issue for years.
According to the insurance industry on the 13th, Boammo recently requested the Financial Services Commission (FSC) to exercise its authority to order Samsung Life Insurance to pay cancer hospitalization insurance benefits. Last month, the FSS’s disciplinary committee issued a “corporate warning” to Samsung Life Insurance for non-payment of cancer hospitalization fees, among other reasons, and the FSC’s final decision is pending.
Boammo claims, “Samsung Life Insurance is withholding thousands of billions of won in insurance payments by citing individual court rulings that differ from the policy terms, and is also engaging in violations of the Insurance Business Act that were neither specified nor explained in the contractual relationship.” They argue that the FSC should exercise its authority to order payment for cancer hospitalization insurance benefits that Samsung Life Insurance has withheld on the grounds of payment restrictions not based on the policy terms and not explicitly stated.
However, even if the FSC finalizes severe sanctions against Samsung Life Insurance, the insurance industry views the payment of hospitalization insurance benefits to Boammo members as a separate matter. This is because the issues related to Boammo were not even discussed during the FSS disciplinary committee review.
Disagreement Over Whether Long-Term Care Hospitalization Is for Direct Cancer Treatment
The core issue in this case is whether cancer insurance hospitalization benefits should be paid when a cancer insurance policyholder is admitted to a long-term care hospital that is not directly related to cancer treatment. The wording in the cancer insurance policy triggered the dispute.
The interpretation of the phrase in the policy, “insurance benefits are paid when surgery, hospitalization, or long-term care is for the direct purpose of cancer treatment,” is contested regarding whether it includes hospitalization in a long-term care hospital. Samsung Life Insurance proposed establishing an arbitration body involving third parties to discuss the matter, but Boammo refused to negotiate.
Past precedents show varied conclusions depending on the case. Especially with the establishment of long-term care hospitals for patients who have undergone cancer treatment, experts differ on whether treatments provided at long-term care hospitals should be considered direct cancer treatment or merely convalescence.
The FSS Dispute Mediation Committee also presented a standard that it is difficult to recognize long-term care treatment for sequelae or complications occurring after cancer treatment or for health recovery as being for the purpose of cancer treatment.
The lawsuit between Boammo representative Mr. Lee and Samsung Life Insurance, ongoing since 2017, ended with a similar conclusion. Mr. Lee, diagnosed with stage 3 breast cancer, received chemotherapy at a university hospital and was also hospitalized at a long-term care hospital for treatment, claiming about 50 million won in hospitalization fees. Samsung Life Insurance denied payment, stating that hospitalization at a long-term care hospital cannot be considered “directly for cancer treatment” under the policy. Both the first and second trials ruled it could not be considered direct treatment, and the Supreme Court also ruled in favor of Samsung Life Insurance.
Currently, some Boammo members continue their illegal occupation. Although the court accepted Samsung Life Insurance’s injunctions last July and August to prohibit assemblies and protests and to prevent business obstruction, and issued orders to prohibit the assembly, Boammo has rejected all of these.
A Samsung Life Insurance official said, “As the illegal protests continue, the company and its employees are suffering tangible and intangible damages,” adding, “While the final decision by the FSC on the disciplinary committee’s ruling remains, the principle is that insurance payments should be made according to the insurance policy and principles.”
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