Samsung Life Insurance-Boammo, Endless Cancer Insurance 'Money Dispute'

Boammo Occupies Samsung Life Customer Center for 1 Year
Supreme Court Rules in Favor of Samsung Life, but Financial Supervisory Service Imposes Severe Sanctions
Protests Continue Despite Assembly Ban and Eviction Orders

[Asia Economy Reporter Oh Hyung-gil] It has been a year since members of the “Cancer Patients’ Association Responding to Insurance Companies (Boammo)” occupied the Samsung Life Insurance customer center and began protesting, yet the conflict over unpaid cancer insurance hospitalization fees for long-term care hospitals remains at a standstill.

Meanwhile, the Supreme Court ruled in favor of Samsung Life Insurance in a lawsuit filed by the Boammo representative, but the Financial Supervisory Service (FSS) ignored the court’s decision that payment was not required and imposed severe sanctions on Samsung Life. Despite court orders banning the assembly and eviction notices, Boammo members have not lifted their occupation protest. Amid conflicting judgments, no one has provided a solution, and the conflict between Samsung Life and Boammo has remained an ongoing issue for years.

According to the insurance industry on the 13th, four Boammo members recently requested the Financial Services Commission (FSC) to exercise its authority to order Samsung Life to pay cancer hospitalization insurance benefits. Last month, the FSS’s disciplinary committee issued a “corporate warning” to Samsung Life for non-payment of cancer hospitalization fees, and the FSC is preparing for a final decision.

Boammo claims, “Samsung Life is withholding thousands of billions of won in insurance payments by citing individual court rulings that differ from the policy terms, and is engaging in violations of the Insurance Business Act that were neither specified nor explained in the contractual relationship.” They argue that the FSC should exercise its authority to order payment for cancer hospitalization insurance benefits that Samsung Life has withheld on the grounds of payment restrictions not based on the policy terms and not explicitly stated.

Supreme Court Sides with Samsung Life, but FSS Imposes Severe Sanctions ? Conflicting Conclusions
Despite Assembly Ban and Eviction Orders, Boammo Continues Protests

The core issue in this case is whether cancer insurance hospitalization benefits should be paid when a cancer insurance policyholder is admitted to a long-term care hospital that is not directly related to cancer treatment. The wording in the cancer insurance policy triggered the dispute.

The parties disagreed over the interpretation of the phrase in the policy stating, “Cancer insurance benefits are paid when surgery, hospitalization, or long-term care is performed for the direct purpose of cancer treatment,” specifically whether hospitalization in a long-term care hospital is included. Samsung Life proposed establishing an arbitration body involving a third party to discuss the matter, but Boammo refused to negotiate.

Past precedents show varied conclusions depending on the case. Especially with the establishment of long-term care hospitals for patients undergoing cancer treatment, experts differ on whether treatments provided in such hospitals should be considered direct cancer treatment or merely convalescence.

The FSS Dispute Mediation Committee also presented a standard stating that it is difficult to recognize long-term care hospitalization for treating sequelae or complications arising after cancer treatment or for health recovery as being for the purpose of cancer treatment.

The lawsuit between Boammo representative Mr. Lee and Samsung Life, ongoing since 2017, ended with a similar conclusion. Mr. Lee, diagnosed with stage 3 breast cancer, received chemotherapy at a university hospital and was also hospitalized at a long-term care hospital for treatment, claiming about 50 million won in hospitalization fees. Samsung Life refused payment, stating that hospitalization at a long-term care hospital cannot be considered “direct cancer treatment” under the policy terms. Both the first and second trials ruled it could not be considered direct treatment, and the Supreme Court also sided with Samsung Life.

Currently, some Boammo members continue their illegal occupation. The court accepted Samsung Life’s injunctions filed in July and August last year to ban assemblies and protests and to prevent business obstruction, issuing an assembly ban order to Boammo, but Boammo has rejected all of these.

A Samsung Life official said, “As the illegal protests continue, the company and its employees are suffering tangible and intangible damages,” adding, “While the final decision by the FSC on the disciplinary committee’s ruling remains pending, the principle is that insurance payments should be made according to the insurance policy and principles.”

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