This Afternoon's Plenary Session Submission
Medical Community Strongly Opposes... "Will Not Hesitate to File Constitutional Lawsuit"
The bill to simplify claims for indemnity health insurance, which had seen no progress for over 14 years, has passed the National Assembly's Legislation and Judiciary Committee. The era where indemnity insurance claims can be automatically processed through electronic systems without submitting documents individually to insurance companies is now within reach.
On the 21st, the Legislation and Judiciary Committee of the National Assembly held a plenary session and approved the amendment to the Insurance Business Act containing these provisions. The bill, first proposed in 2009 following a recommendation by the Anti-Corruption and Civil Rights Commission to simplify the indemnity claim process, has finally overcome the final hurdle after 14 years.
The amendment to the Insurance Business Act allows medical institutions to act on behalf of patients in filing indemnity insurance claims. Once this law is enacted, indemnity insurance subscribers will no longer need to collect various paper documents; they can simply request the hospital after treatment, and the insurance claim will be automatically filed.
If the bill is presented in the plenary session this afternoon, the simplification of indemnity claims is expected to become a reality. The insurance industry anticipates the bill will pass if the plenary session proceeds normally, as there was little opposition during the amendment approval process. Previously, Park Jumin, a member of the Democratic Party of Korea, opposed the amendment during the Legislation and Judiciary Committee plenary session held on the 13th, but did not raise any objections this time.
With nearly 40 million subscribers, indemnity insurance has been called the "second national insurance." However, the requirement for subscribers to personally obtain various documents from hospitals and submit them to insurance companies had been a major issue. According to a 2021 survey by the Green Consumer Network, Consumers Together, and the Financial Consumers Federation, 47.2% of indemnity insurance subscribers gave up on filing claims due to reasons such as the small amount involved, failure to gather necessary documents, or the hassle of submitting proof documents. From the insurers' perspective, the amendment is welcomed as it reduces inefficient tasks of verifying printed documents from electronic information and re-entering data into systems.
However, the bill repeatedly failed to pass the National Assembly due to opposition from the medical community. They argued that medical information of indemnity insurance subscribers could be leaked through specialized intermediary agencies entrusted with the claim process. In particular, they strongly opposed the Health Insurance Review and Assessment Service (HIRA) becoming the intermediary agency, fearing that non-reimbursable treatment details from hospitals and clinics would be transferred to HIRA. This would allow the government and insurers to clearly identify and control non-reimbursable information.
Since the medical community still opposes the bill, controversies are expected to continue until the final passage of the amendment to the Insurance Business Act. The medical community claims that if patients' medical information is collected by intermediary agencies, insurers could use it to refuse insurance enrollment or claim payments for certain groups. They have expressed willingness to pursue constitutional litigation if necessary.
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