On Mar. 5, SK FSC proposed revising claim documents transmission.
SK FSC proposed revisions to the Enforcement decree of the insurance business act.
Follows SK FSC, FSS Nov. 2023 TF meeting on claim computerization, see #190206.
Revisions
Policyholders can request electronic transmission of insurance claim documents from medical institutions; the transmitted documents must be in a form to be processed by information processing devices, meet requirements for personal data protection.
Stipulate exceptional cases where medical entities would not be required to transmit claim documents electronically, e.g., inability to use computer system due to defects.
Designate the Insurance Development Institute as a document transmission agency.
Specify the composition and operation of the actual loss insurance computer system operation committee, which will conduct coordination among related organizations in the electronic claim process, research on ways to improve electronic claims.
Effectiveness
Comments to be sent by Apr. 15, 2024; for planned effectiveness from Oct. 25, 2024.
In Jul. 2024, SK FSC proposed revisions re insurance claim documents, see #218984.
In Jul. 2024, SK FSC issued minutes for 9th review meeting in 2024, see #219228.
Sep. 2024 Meeting
On Sep. 12, 2024, SK FSC held a meeting on computerization of actual loss insurance claims, with SK MOHW, electronic medical record (EMR) firms, the insurance industry.
Ahead of the implementation of the revisions detailed above, on Oct. 25, 2024.
Requested EMR firms and electronic transmission agencies to finalize an appropriate cost level promptly; clarified that hospitals do not bear any administrative burden.
As per the Insurance business act, medical institutions shall transmit documents, while insurance companies shall build, operate a computer system, bear the costs thereof.
SK FSC will devise measures ensuring that insurance companies respond to civil complaints, by sending advance notices to subscribers, running dedicated call centers.
Clarified that the concentration of medical information by transmission agencies are legally banned; the medical community may periodically monitor the concentration of information by participating in the operation of transmission agencies upon its request.
SK FSC will strengthen publicity and communication with the medical community and EMR companies, to expand participation of medical institutions prior to the implementation of computerization of actual loss insurance claims from Oct. 25, 2024.
On the same day, SK GVT proposed revisions to insurance claims, see #225920.
Regulators
SK FSC
Entity Types
Ins
Reference
Mt, DB, PR, 9/12/2024; CP, Nt 2024-64, PR, 3/5/2024; Dec 34083, 12/29/2023; Law 19780, 10/24/2023;
