Addition of Fault Inquiry Between Insurers... Financial Supervisory Service Revises Car Insurance Compensation Procedures

Preparation of Procedures for New Terms Application

[Asia Economy Reporter Minwoo Lee] From the new year, if you sustain minor injuries in a car accident, you will be responsible for medical expenses in proportion to your fault, and excessive medical treatment will be prohibited due to the revision of insurance terms. In relation to this, the Financial Supervisory Service (FSS) has revised various procedures and established a customer guidance system.

On the 28th, the FSS announced that it had reorganized the compensation procedures together with the non-life insurance industry. According to the FSS, starting next year, with the revision of the terms, the portion of medical expenses for minor injury patients (injury grades 12 to 14) under Liability Insurance II (which covers damages exceeding the mandatory Liability Insurance I) corresponding to the insured’s own fault must be covered by the insured’s own insurance or out-of-pocket. Additionally, if a minor injury patient receives long-term treatment exceeding four weeks, a medical certificate must be submitted.

The FSS has revised various procedures to prevent inconvenience to consumers due to these changes. First, since the insured’s fault will be reflected in the medical expenses under Liability Insurance II and disputes over fault ratios are expected to increase, a 'Fault Inquiry Service' has been added to the AOS system (an inter-insurer business system connection), and records of fault negotiation history will be stored.

If a dispute over fault ratio arises from a car accident, it will be possible to request a review by the Fault Ratio Dispute Review Committee even before insurance payments are made. Previously, the review was limited to subrogation disputes between insurers.

The recovery of the insured’s share of medical expenses will also be minimized. First, when the liability insurer and the minor injury patient reach a settlement, if there is a remaining balance of the settlement amount such as consolation money or damages beyond medical expenses, a new procedure has been established to offset the insured’s share of medical expenses from the remaining settlement balance.

In procedures between insurers, if the liability insurer receives the 'right to claim personal injury insurance benefits' from the minor injury patient, it can claim the insured’s share of medical expenses from the subrogated insurer within that limit.

Additionally, if a minor injury patient receives treatment exceeding four weeks without submitting a medical certificate, the insurer will send a 'Notice of Suspension of Payment Guarantee' to the medical institution starting from the day after the four-week period. If the patient submits the medical certificate after four weeks, medical expenses for the period without submission will not be recognized.

The FSS plans to notify these changes via 'AlimTalk' messages, as well as conduct online promotions and deploy dedicated counseling personnel.

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