Digitalization Participation Rate for Indemnity Claims Reaches 59.1%... Authorities to Promote Activation Measures

Financial Services Commission Holds Meeting on Digitalization of Indemnity Insurance Claims
Seeking Activation Measures Ahead of Second Phase Launch on October 25
Plans to Expand Incentives for Participation by Medical Institutions and EMR Companies

The Financial Services Commission announced on August 7 that it held an inspection meeting with related organizations to promote the second phase of digitalization for indemnity insurance claims, which is scheduled for October 25.

The digitalization of indemnity insurance claims was first implemented on October 25 of last year, targeting approximately 7,800 hospital-level medical institutions and public health centers. Starting from October 25 of this year, the initiative will be expanded to include about 96,000 clinics and pharmacies.

As of August 5, among the institutions eligible for digitalization, 6,757 (1,045 hospitals, 3,564 public health centers, 861 clinics, and 1,287 pharmacies) are actually participating, resulting in a participation rate of 59.1%. Although the revised Insurance Business Act has not yet come into effect for clinics and pharmacies in the second phase, those clinics and pharmacies that wish to participate are being proactively supported to do so. Currently, the participation rate for the second phase is about 2.2%.

So far, the financial authorities have made multifaceted efforts together with relevant organizations to expand the participation of medical institutions in the digitalization of claims. The Korea Life Insurance Association, the General Insurance Association of Korea, and the Insurance Development Institute, which operates the digitalization system, have discussed financial and technical support measures with medical associations, pharmacy associations, and electronic medical record (EMR) companies. The insurance industry and related organizations are providing support to participating medical institutions and EMR companies in the form of server costs, system development expenses, expansion incentives, and maintenance fees. However, during the process of discussing support measures for some hospital-level institutions in the first phase and for medical institutions in the second phase, differences in opinion have arisen due to excessive fee demands, and these differences have not yet been resolved.

The financial authorities are also working to promote the dedicated digital claims application, "Silsun24," by enabling consumers to easily find and use participating hospitals through integrated search services on map platforms such as Naver Map and Kakao Map. They have improved the system by adding a feature that allows consumers to request participation from non-participating medical institutions. A non-member claim function has also been developed, making it easier to file claims without registering as a member. Additionally, the period for searching "hospitals I have visited" has been shortened from one week to one day, allowing consumers to more conveniently look up their medical history.

Security for the digital claims system has also been strengthened. Strict measures to ensure safety and protect personal information in accordance with the Insurance Business Act and related regulations have been implemented, and a high level of system security has been achieved through security inspections by the Financial Security Institute and personal information impact assessments.

According to a survey conducted in April by the consumer group "Consumers Together," both consumers using the digital claims system and participating hospitals have given positive evaluations of Silsun24. 89% of consumers responded that the digitalization of claims is more convenient than the previous insurance claim process. 94% said they intend to continue using Silsun24. The most cited reason for preferring digitalization, mentioned by 86% of respondents, was the ability to claim insurance benefits without issuing paper documents such as medical bills. Among participating hospitals, 67% said that the administrative burden of issuing claim documents has decreased, and 79% said that it has helped improve patient service satisfaction.

The Financial Services Commission plans to use this inspection meeting to raise awareness of digital claims among the public and the medical community, and to encourage more medical institutions to participate by launching a nationwide promotional campaign for Silsun24 starting August 11.

Plans are also in place to further promote the activation of digital claims. The main directions are: ▲ enhancing the utility of the service for consumers, ▲ increasing incentives for participation by medical institutions and EMR companies, and ▲ exploring ways to link the system with medical administration. Initiatives include consumer events such as awarding Naver Pay points for claims filed through Silsun24, reducing guarantee fees and fire insurance premiums for participating medical institutions and EMR companies through policy financial institutions, and seeking ways to connect with medical administration through consultations with the Ministry of Health and Welfare and other relevant ministries.

An official from the Financial Services Commission stated, "Through this inspection meeting, we will do our utmost to ensure thorough preparation for the smooth implementation of the second phase," and added, "We will discuss and announce tasks to promote the activation of digital claims at the Silsun Digital Operation Committee, which will include consultations with relevant ministries and the medical community, including healthcare organizations."

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