[Public Voices] Car Insurance Must Prevent Reckless Overtreatment

Victims of System Abuse Harm Honest Policyholders
Ensuring Appropriate Treatment While Preventing Excessive Medical Claims

Seonjeong Kim, Specially Appointed Professor at Dongguk University School of Law (Former President of the Korean Insurance Law Association)

A vehicle changing lanes almost collided with a car traveling straight, forcing a sudden stop. Fortunately, a crash was avoided. However, the driver of the other vehicle, who showed no clear signs of injury, received outpatient treatment for 500 days and claimed 20 million won in medical expenses through insurance. In another case, while reversing in a parking lot, a car scratched the bumper of a parked vehicle. As a result, the driver of the other vehicle received outpatient treatment for 150 days and claimed 14 million won in medical expenses through insurance. These are not fabricated stories. They are just some of the many cases that have occurred in Korea so far.

Life without cars is impossible, but anyone can potentially cause or suffer an accident. This is why such risks are called "permitted risks." Insurance is the primary system designed to prepare for unavoidable risks that occur despite careful driving. The necessity of insurance is so high that it has become a legal obligation, and 26.5 million people in Korea are insured. For this public risk-sharing mechanism to work properly, there are ethical boundaries that society members must observe. However, there has been a growing number of cases where some victims and stakeholders abuse the system. This is an urgent issue that our society must address, and it is the responsibility of policymakers.

The increasingly serious issue of "prolonged treatment for minor injuries" is another problem that must be solved. The government has gathered extensive input to address this worsening phenomenon, which is largely due to unscrupulous stakeholders, and has announced legislative improvements. The core of the new legislation is to ensure that sufficient treatment is provided within the usual treatment period, while establishing clear criteria for determining whether continued treatment is necessary when this period is exceeded.

Therefore, concerns that the new system will restrict doctors' right to treat or patients' right to receive treatment are unfounded and stem from a misunderstanding of the system's intent. It is questionable to defend excessive treatment as a right, especially when many drivers have been unfairly held responsible due to fraudulent patients, and some victims' over-treatment has already reached the level of criminal activity. The government proposal does not seek to block all treatment, but rather aims to guarantee appropriate treatment for actual injuries to the fullest extent. The main goal is to establish reasonable standards for treating injuries that are objectively linked to the accident, rather than relying solely on patient statements. This proposal is the result of a broad social consensus formed by gathering the wisdom of various members of our society over a significant period. Its content is reasonable in light of public interest and is not excessive compared to international trends. For example, Germany limits insurance payouts for minor accidents occurring at speeds below 11 km/h, Spain does so for accidents below 8 km/h, Ontario in Canada sets caps on the duration and cost of treatment for minor injuries, and the United Kingdom has completed the necessary legislative procedures.

Korea must also put a rational brake on the practice of "excessive treatment" that has continued without objective standards. Medical practices based mainly on patients' subjective complaints cannot be considered scientific. There is no reason for honest insurance policyholders to bear the financial burden caused by these inappropriate practices. At the same time, since the new system includes relief procedures in the event of disputes, it must be designed to ensure that no one is unfairly excluded from necessary treatment. While maintaining the intent of the system, authorities and related industries must continue to monitor the situation in the field and listen to the suggestions of stakeholders to ensure that patients who genuinely require long-term treatment are not disadvantaged due to difficulties in preparing documents or rigid procedures.

Seonjeong Kim, Specially Appointed Professor at Dongguk University School of Law (Former President of the Korean Insurance Law Association)