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Loss insurance payments are increasing...Will claims be simplified 'fi…
lemonhealthcare 2023-05-15
While the government and the National Assembly have recently been busy discussing simplifying claims for medical insurance, fintech companies are introducing "Simplifying Insurance Claims" services to minimize inconvenience to consumers. Unlike in the past, convenience has increased, but there are areas where it is difficult to be a perfect alternative due to the need to issue documents directly and services centered on university hospitals.

According to data submitted by Lee Jong-sung, a member of the People's Power of the National Assembly's Health and Welfare Committee, from the Non-life Insurance Association on the 19th, the amount of real-life insurance payments last year was 10.59 trillion won, up 3.2% from the previous year.

Loss insurance payments exceeded 10 trillion won for the second consecutive year, and reached a new record last year.
 

Insolvency insurance is an insurance that guarantees out-of-pocket expenses among non-payment medical usage fees and health insurance coverage that are not covered by health insurance, and as of the end of March last year, 39.77 million subscribers signed up and are recognized as "second health insurance."


The amount of payments is increasing every year as many people claim insurance as they have signed up, but the process to claim them is still in the past.

In order to simplify claims for loss insurance, the Presidential Digital Platform Government Committee prepared the "Digital Platform Government Health and Medical Leading Task TF" last year to discuss ways to computerize claims for loss insurance.

On the 9th, △ National Assembly Health and Welfare Committee △ Financial Committee △ Korean Medical Association △ Korean Hospital Association △ Life Insurance Association △ Non-life Insurance Association, etc. gathered to hold an "eight-party consultative body" to simplify claims for loss insurance.

An insurance industry official explained, "We have been conducting bills or discussions at the National Assembly to simplify claims for loss insurance, and discussions are being conducted in two ways, including the formation of a TF at the government level."

Big tech and fintech companies are introducing services that allow you to easily claim insurance money directly. Representatively, Lemon Healthcare provides simple billing services in cooperation with more than 80 hospitals, including major domestic high-level hospitals such as Seoul National University Hospital and Sinchon Severance Hospital, through the "God of Claiming" app.

In December last year, it opened an "automatic claim for loss insurance" service that automatically claims outpatient treatment cases accumulated three times a month without additional procedures. Through this, Lemon Healthcare explained that the annual accumulated number of claims for loss insurance through "God of Claims" exceeded 1 million.

On top of that, subscribers who have two or more loss insurance policies using Toss or Kakao Pay can claim insurance money from multiple insurance companies at once with one app.


Fintech companies provide simple insurance billing services, but it is difficult to be a perfect alternative. In the case of Lemon Healthcare's service, claims can be made mainly at large general hospitals, so if you want to claim loss insurance after using a local hospital or pharmacy, you still need to get a receipt and a medical certificate and submit it to the insurance company.

In the case of simple claims provided by big tech companies, real receipts and medical certificates must be photographed and submitted to claim insurance money, and in the case of high treatment costs of more than 2 million won, each insurance company has different documents to submit.

Another insurance industry official said, "Although several fintech companies provide services to simplify claims for real-life insurance, there is a part that consumers have to do themselves in claiming insurance through apps or kiosks in hospitals," adding, "It is true that convenience has increased compared to the past, but it is necessary to simplify claims that allow small-scale medical cases to be claimed without omission as the contents are delivered directly to insurance companies after hospital treatment."

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