85 Million Won Annually on Manual Therapy?…This Year's Actual Loss Insurance Claims Soar to 1.6 Trillion Won

"Insurance Companies Must Establish Standards to Control Over-Treatment"

#Last year, Mr. A, a man in his 40s, claimed 85 million KRW in indemnity insurance benefits over approximately 11 months. He received inpatient and outpatient treatment at eight medical institutions, undergoing a total of 342 sessions of non-reimbursable physical therapy, including 23 sessions of manual therapy and 309 sessions of extracorporeal shock wave therapy.

The indemnity insurance payments for non-reimbursable physical therapies such as manual therapy have continued to increase this year, reaching already 1.6 trillion KRW. At this rate, it is expected to surpass last year's amount, which first recorded over 2 trillion KRW.

According to data requested by Kang Min-guk, a member of the People Power Party, from the General Insurance Association on the 31st, indemnity insurance payments for non-reimbursable physical therapies such as manual therapy, extracorporeal shock wave therapy, and proliferative therapy amounted to 1.562 trillion KRW (7.84 million cases) as of August this year.

By year, indemnity insurance payments for non-reimbursable physical therapy were 1.8468 trillion KRW (9.36 million cases) in 2021, 1.8692 trillion KRW (9.86 million cases) in 2022, and 2.127 trillion KRW (11.52 million cases) last year, showing an increasing trend annually. If the current trend continues this year, it could exceed the early 2 trillion KRW level recorded last year.

Looking at the types of non-reimbursable physical therapy, insurance payments for manual therapy were the highest at 945.1 billion KRW. Extracorporeal shock wave therapy followed with 348.4 billion KRW, proliferative therapy with 176.1 billion KRW, and others with 92.1 billion KRW.

The fundamental reason for excessive physical therapy is that, unlike reimbursable treatments covered by the National Health Insurance, there are no treatment standards for non-reimbursable therapies, according to analyses from the property and casualty insurance sector. Concerns continue to be raised that the abuse of non-reimbursable treatments leading to leakage of indemnity insurance payments may result in premium increases, thereby transferring harm to many policyholders.

Assemblyman Kang Min-guk pointed out, "It is questionable whether receiving manual therapy hundreds of times amounting to nearly 100 million KRW is related to normal patient treatment," and added, "To eradicate such abnormal excessive physical therapy, financial authorities need to provide guidance so that insurance companies can control excessive treatments based on reasonable standards."