[Becoming an Insurance Insider] 'National Insurance' Actual Expense Coverage... Which Insurer Offers the Best Benefits?

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[Asia Economy Reporter Oh Hyungil] Hanwha Life recently lowered the upper age limit for new subscriptions to indemnity medical insurance from 65 to 49 years old. Instead, those aged 50 to 75 who wish to subscribe to indemnity insurance can only enroll in the relatively expensive senior indemnity insurance. This is a desperate measure taken due to the recent increase in the loss ratio of indemnity insurance.

The criteria for visit diagnosis screening when subscribing to indemnity insurance have also been strengthened. The screening method, which was previously conducted in writing, now involves a nurse visiting the customer directly to conduct a physical examination. If health problems are found, the insurance premium is raised or the subscription is denied. There are also about ten insurance companies that do not sell indemnity insurance at all.

The trend of making it increasingly difficult to subscribe to indemnity insurance continues. If you have not yet subscribed to indemnity insurance, which insurance company would be beneficial to join?

The answer, from the outset, is "depending on the situation." This is because the coverage details of indemnity insurance are the same regardless of which insurance company you subscribe to.

The indemnity insurance currently sold is a standardized product, and all insurance companies provide the same coverage. It can be renewed annually with a 15-year policy amendment condition and provides coverage up to 100 years of age.

The most important coverage in indemnity insurance, inpatient medical expenses, covers the amount excluding 10% of covered expenses and 20% of non-covered expenses within a limit of 50 million KRW. However, the deductible is up to 2 million KRW.

Outpatient medical expenses can be supported up to a daily limit of 250,000 KRW after deducting the larger amount between 10,000 KRW for general clinics, 15,000 KRW for general hospitals, 20,000 KRW for advanced hospitals, and 10% of covered expenses or 20% of non-covered expenses.

In particular, for MRI or MRA, non-covered injection fees, manual therapy, extracorporeal therapy, and proliferation therapy, coverage can be received by paying a deductible through special contracts.

The problem is that due to the loss ratio, cases of reluctance to underwrite indemnity insurance alone are increasing. There is an implicit practice of requiring subscription to guaranteed insurance products such as cancer insurance or children's insurance (for those under 30) in order to receive indemnity insurance.

An insurance industry official said, "Considering the current loss ratio, premiums must inevitably be raised, but it is realistically difficult to increase them due to consumer burden," adding, "Some insurance companies have no choice but to limit subscriptions as a self-help measure."

This content was produced with the assistance of AI translation services.