'Indemnity Insurance Overlap' Advisory... Financial Supervisory Service: "Individual Policy Suspension Possible When Enrolled in Group Insurance"

Repeated Damages from Overlapping Enrollment in Group and Individual Indemnity Insurance
Reversion to 5th Generation Policy Allowed Within Six Months... Only Once Permitted

#Mr. A filed a compensation complaint, stating that after joining the company and enrolling in the group indemnity medical insurance, he continued to pay premiums for his individual indemnity insurance but was unable to use the premium suspension system, resulting in double payments.

The Financial Supervisory Service has issued a notice regarding key precautions, as there have been repeated cases where individuals were unaware that they could suspend premium payments for their individual indemnity insurance after enrolling in group indemnity medical insurance, leading to overlapping premium payments.

On May 19, the Financial Supervisory Service provided guidance on such indemnity insurance-related complaints and key precautions.

In cases where a person is enrolled in both individual and group indemnity insurance, it is possible to request a suspension of premium payments for individual insurance or partial suspension of certain coverages. Only overlapping coverage items (such as accident or illness hospitalization) can be suspended. If the overlapping coverage items do not match due to the structural differences between the two insurance products, suspension is possible with the individual's consent.

If the group indemnity insurance is terminated due to resignation or other reasons, and an application is made within one month, the individual indemnity insurance can be resumed without a separate review. The policyholder can choose between the product held at the time of suspension or products being sold at the time of resumption. However, this is restricted if the main contract was canceled or if the resumption application is made after one month. Additionally, if the period not covered by either group or individual indemnity insurance exceeds one month on any occasion or three months in total after suspending the individual indemnity insurance, resumption is not possible.

Furthermore, if a policyholder applies to switch to 5th generation indemnity insurance and no reason for a claim arises, it is possible to revert to the previous contract within six months—this is allowed only once. Even if a claim arises after the switch, the contract can be reverted within three months from the application date for the switch. However, if the policyholder withdraws the switch, the premium difference between the switched contract and the original contract must be settled, and any claims that occurred after the switch will be covered by the original contract.

Indemnity medical expense riders for overseas travel insurance do not provide overlapping compensation with domestic indemnity insurance. Instead, “proportional compensation” applies, meaning the two insurances share the actual paid medical expenses.

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