"Do You Have 실손 Insurance?" More Than Half of Patients Have Heard It at Hospitals

[Asia Economy Reporter Changhwan Lee] More than half of insurance policyholders have experienced being asked whether they have signed up for indemnity health insurance (실손보험) when visiting a hospital.

According to the '2022 Insurance Consumer Behavior Survey Report' by the Korea Insurance Research Institute on the 25th, 57.7% of insurance policyholders had been asked by hospital staff whether they were enrolled in indemnity insurance when visiting a hospital for treatment.

The Korea Insurance Research Institute conducted this survey in August with 3,500 adult men and women nationwide who had insurance policies.

Regarding the confirmation of indemnity insurance enrollment, women more than men, middle-aged and older adults in their 50s and 60s more than younger generations, and those with prior insurance claim experience more than those without were more likely to have been asked. This is interpreted as these groups having relatively more hospital visits.

Insurance policyholders generally evaluated that overtreatment is widespread in manual therapy and cataract surgery.

When asked how often they think manual therapy is overused even for mild symptoms where it is not essentially necessary, 34.2% answered that it happens frequently. 32.6% responded that it happens occasionally.

Regarding cataract surgery, 23% evaluated that it is overused, and 30.8% answered that it happens occasionally.

Regarding inconveniences in the insurance claim review process for various insurance products such as indemnity insurance and life insurance, most respondents expressed general satisfaction.

Regarding the insurance claim processing period, 85.3% of respondents said the processing time was reasonable. When asked whether it is reasonable for insurance companies to request additional documents from beneficiaries to verify facts or assess medical appropriateness, 84.3% answered that it was reasonable.

However, the positive response rate to the question about non-payment of interest due to delayed insurance payments if one refuses to consent to a written investigation without justifiable reasons was 63%, which was lower than other questions. This is analyzed as a situation where dissatisfaction inevitably arises due to delays in insurance payments.

Byun Hyewon, a research fellow at the Korea Insurance Research Institute who authored the report, stated, "Recently, as review standards related to indemnity insurance or private medical insurance have been strengthened, complaints related to additional document requests or non-payment of insurance claims have also increased," adding, "In the fair insurance claim review process, consumers may inevitably feel inconvenienced, so insurance companies need to seek ways to alleviate consumer dissatisfaction."