Will a Consultation Body for Subrogation Claims Between NHIS and Insurance Companies Be Established?

Proposed Amendment to the National Health Insurance Act

On the 1st, cherry blossoms are in full bloom along Yeouiseo-ro near the National Assembly building in Yeongdeungpo-gu, Seoul, under warm spring weather. Yeongdeungpo-gu will accept applications for entry to the Yeouiseo-ro cherry blossom path on the spring flower festival website in three sessions: April 1-2, 5-6, and 7-8. From 11 a.m. to 9 p.m., 72 people can enter at a time, allowing a total of 504 visitors per day to enjoy the festival with limited capacity. Photo by Moon Honam munonam@

[Asia Economy Reporter Oh Hyung-gil] A legislative amendment is being promoted to reduce subrogation claim lawsuits between the National Health Insurance Service and non-life insurance companies over traffic accident medical expenses.

On the 7th, Kim Seong-su, a member of the Democratic Party of Korea (secretary of the National Assembly Health and Welfare Committee), introduced a partial amendment bill to the National Health Insurance Act that allows the Health Insurance Service to establish and operate a 'Subrogation Claim Consultation and Adjustment Organization.'

The Health Insurance Service claims the full amount of medical expenses borne by the Service due to traffic accident damages involving insured persons or their dependents from the at-fault party.

However, when the at-fault party's non-life insurance company refuses to pay the subrogation claim by arguing the application of fault ratios between the at-fault and the victim, the fault ratio can only be applied through litigation, resulting in many cases proceeding to lawsuits.

There were 492 cases in 2018, followed by 514 cases in 2019, and 397 cases in 2020.

Repeated lawsuits delay the recovery of subrogation claims and cause waste of administrative costs due to collection demands and litigation. This also causes significant inconvenience and cost waste for the at-fault parties and private non-life insurance companies.

The amendment allows the Health Insurance Service to establish a subrogation claim consultation and adjustment organization, enabling the Service and non-life insurance companies to negotiate and adjust the claim amount before proceeding to litigation.

Representative Kim stated, "If both the Service and insurance companies can reach an amicable agreement, it is expected to reduce unnecessary lawsuits, enable early recovery of subrogation claims, reduce administrative costs, and improve convenience for insured citizens."