Unlicensed and Signal Violation 'Electric Scooter' Accidents Are Not Covered by Health Insurance

Restrictions and Recovery Measures on Health Insurance Benefits for Traffic Law Violations

If an accident occurs due to a violation of traffic laws while riding an electric kickboard, caution is required as health insurance coverage may not apply when receiving hospital treatment.

The National Health Insurance Service (NHIS) announced on the 1st that if an accident occurs due to a violation of traffic laws while operating personal mobility devices such as electric kickboards, it falls under the benefit restriction according to Articles 53 and 57 of the National Health Insurance Act, and the NHIS’s burden for injury treatment costs may be reclaimed.

According to the Ministry of the Interior and Safety, traffic accidents involving personal mobility devices increased more than fivefold from 447 cases in 2019 to 2,389 cases in 2023, with accidents involving drivers aged 20 or younger accounting for 70% of these. In particular, traffic accidents caused by unlicensed driving and signal violations by middle and high school students, who lack understanding of related laws such as the Road Traffic Act, are increasing, highlighting the need for public awareness about safe driving.

The NHIS considers it unjust enrichment and reclaims insurance benefit costs when a traffic accident occurs due to violations of the 12 major obligations, such as unlicensed driving, signal violations, and drunk driving, while riding personal mobility devices, and treatment is received for related injuries.

For example, last year, a minor named A was injured in a collision with a vehicle after violating a traffic signal while riding an electric kickboard without a license, resulting in about 40 million KRW in treatment costs (NHIS burden). The NHIS regarded the cause of the accident as a "criminal act due to gross negligence" and issued a notice to reclaim the unjust enrichment amount.

However, the NHIS explained that in cases of benefit restrictions due to traffic accidents, the Health Insurance Appeals Committee comprehensively considers the circumstances and nature of the accident at the time it occurred to determine the causal relationship between the legal violation and the insurance accident, and strives to protect the insured’s health insurance benefits.

Currentlyryong, Chairman of the Health Insurance Appeals Committee, stated, "Personal mobility devices, including electric kickboards, are classified as 'vehicles' under the Road Traffic Act," and urged, "Since health insurance benefits may be restricted when injuries occur due to traffic accidents caused by unlicensed driving, signal violations, etc., please be especially careful not to violate traffic laws."

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