"Consumer Complaints About Silson Insurance Surge 3.3 Times in the Last 5 Years"

[Asia Economy Reporter Changhwan Lee] Consumer complaints regarding indemnity health insurance products have surged sharply. Most complaints were related to refusals of indemnity insurance payments.

According to data submitted by the Korea Consumer Agency to Song Seok-jun, a member of the National Assembly's Political Affairs Committee from the People Power Party, the number of consumer complaint consultations related to indemnity insurance increased about 3.3 times over five years, from 961 cases in 2017 to 3,205 cases as of September 21, 2022.

Looking at the numbers by year, the number of indemnity insurance consumer complaint consultations was under 1,000 annually with 961 cases in 2017, 986 in 2018, and 956 in 2019. However, it increased to 1,051 cases in 2020 and 1,451 cases in 2021, showing an upward trend, and surged significantly to 3,205 cases this year.

The highest growth rate in consultation cases was for after-service (AS) complaints, which increased about 20 times from 4 cases in 2017 to 81 cases in 2022. Consultations related to contract non-fulfillment (incomplete fulfillment) rose about 7.7 times from 191 cases in 2017 to 1,467 cases in 2022, followed by consultations related to policy terms increasing about 6.9 times from 50 to 347 cases.

Consumer complaints about indemnity insurance mainly involved core aspects of indemnity insurance contracts such as refusal of indemnity payment, sharp premium increases, and unfair policy terms.

One major complaint case involved the insurer presenting unfair conditions to the consumer and failing to fulfill the contract. Mr. A, who subscribed to indemnity insurance, requested payment for knee cartilage surgery and treatment, but the insurer refused payment for manual therapy. Mr. A then demanded payment again according to the policy terms.

The insurer offered to pay the insurance money if Mr. A agreed not to claim insurance payments for future manual therapy and extracorporeal shock wave therapy costs, but Mr. A objected, claiming this was unfair.

Complaints due to premium increases were also received. Mr. B, an insurance subscriber, received a text message from the insurer stating that next year's premium would increase from 21,000 KRW to 69,000 KRW. When he inquired with the insurer, he was told the increase was decided based on market conditions, and he requested consultation, arguing that the increase amount was excessive.

Assemblyman Song said, “Recently, consumer complaints about indemnity insurance have exploded due to insurers’ unfair condition proposals, excessive premium hikes, and complex policy terms leading to refusal of insurance payments.” He added, “Relevant authorities should analyze complaint cases and proactively inform consumers about major dispute types to prevent damages.”

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