943,000 People Received Double Payments Over Four Years
This Raised the Indemnity Insurance Loss Ratio by 2.3 Percentage Points
A bill aimed at addressing the issue of double payments involving National Health Insurance refund limits and private indemnity health insurance benefits has been introduced in the National Assembly.
Choo Kyung-ho, a member of the People Power Party, announced on the 18th that he had sponsored partial amendments to the National Health Insurance Act and the Insurance Business Act to establish a legal framework for linking the management of the national health insurance and indemnity insurance systems.
The National Health Insurance refund limit system reimburses patients for medical expenses that exceed a certain annual threshold, serving as a safeguard to prevent households from collapsing under excessive medical costs. However, there have been ongoing concerns that some patients receive these refunds while simultaneously claiming the same amount from indemnity insurance, thus enjoying double benefits.
According to the Board of Audit and Inspection, from 2019 to 2022, a total of 943,000 indemnity insurance policyholders received overlapping payments from both the National Health Insurance refund limit system and indemnity insurance, amounting to 858 billion won in total. The Board of Audit and Inspection analyzed that if these duplicate payments were eliminated, the loss ratio for indemnity insurance would decrease by 2.3 percentage points and annual insurance premiums could be reduced by approximately 223.2 billion won. The agency pointed out that such double payments not only worsen the finances of the national health insurance system but also contribute to rising indemnity insurance premiums.
To address these issues, Choo sponsored partial amendments to the National Health Insurance Act and the Insurance Business Act. The core of the amendments is to require the Ministry of Health and Welfare and the Financial Services Commission to coordinate and connect policies for national health insurance and indemnity insurance, as recommended by the Board of Audit and Inspection. The intent is to jointly investigate the operation of both systems and systematically manage the issue of overlapping compensation.
Choo stated, "It is unfair that some people receive benefits twice while others bear the burden," adding, "Through legislative amendments, I will work to prevent unnecessary fiscal waste and reasonably reduce the burden of medical expenses on the public."
The refund limit system reimburses patients for medical expenses that exceed a certain annual threshold, serving as a safeguard to prevent households from collapsing under excessive medical costs. However, it has been confirmed that some patients have received these refunds while also claiming the same amount from indemnity insurance, thereby enjoying 'double benefits.'
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