Consumer Groups: "Half of Policyholders Do Not File Claims for Real Loss Insurance... Need to Expedite Claim Computerization"

Experience of Unclaimed Actual Medical Insurance (Source: Green Consumer Network)

[Asia Economy Reporter Oh Hyung-gil] It has been found that one out of two consumers gave up on claiming reimbursement from their actual medical expense insurance. Eighty-five percent of consumers agreed to the method of sending supporting documents from the hospital where they received treatment to the insurance company with their consent.

On the 6th, three civic groups?Green Consumer Network, Consumers Together, and the Financial Consumers Federation?announced the results of a survey on the awareness of actual medical expense insurance claims conducted on 1,000 general citizens aged 20 or older who have been enrolled in actual medical expense insurance within the last two years.

Among the respondents, 47.2% had experience giving up on claiming actual medical expense insurance reimbursement within the past two years despite being eligible to claim. Of the amounts they gave up claiming, 95.2% were small claims of 300,000 KRW or less.

The reasons for giving up on claims included the treatment cost being low (51.3%), not having time to revisit the hospital to collect documents to submit to the insurer on the day of treatment (46.6%), and the hassle of sending supporting documents (23.5%).

While 36.3% of respondents said the current actual medical expense insurance claim process is convenient, 78.6% answered that a computerized claim system is necessary for actual medical expense insurance claims.

Improvement of Actual Expense Insurance Claim System (Source: Green Consumer Network)

In particular, when sending supporting documents electronically for insurance claims, consumers preferred that the related computerized system be operated by a public institution with strong personal information protection and high reliability, rather than by private fintech companies or insurance-related organizations.

Consumer groups stated, "Although the Anti-Corruption and Civil Rights Commission recommended in 2009 to resolve the inconvenience of the actual medical expense insurance claim procedure, it has been reconfirmed that consumers still give up on claims due to the inconvenience of the process."

Four bills to amend the Insurance Business Act for the computerization of actual medical expense insurance claims were proposed in the 21st National Assembly, but they remain at the discussion stage due to opposition from the medical community.

The groups emphasized, "The computerization of actual medical expense insurance claims is not about the interests of the medical community or insurance companies but is a system improvement aimed at enhancing the convenience of 39 million consumers currently enrolled in actual medical expense insurance. Since both ruling and opposition parties have proposed bills for claim computerization, we strongly urge that these bills be passed promptly without being swayed by interest groups."

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