On Sep. 5, 2025, SK FSC held an actual loss insurance computer system operation committee meeting to decide on basic matters re its composition and operation.
To discuss plans to facilitate the computerization of actual loss insurance claims, ahead of the second-phase implementation with clinics and pharmacies from Oct. 25, 2025.
SK FSC will induce consumers to directly request electronic transmission of insurance claim documents from medical institutions by improving service effectiveness.
To this end, Silson24 will be actively linked to online platform services; consumers who file insurance claims via Silson24 will be given cashback points from online platforms.
Insurers will expedite payment within 24 hours for outpatient claims under KRW 300k made via Silson24 which do not require review; Silson24 services will be improved by simplifying identity verification and developing a document supplementation function.
Financial authorities and related entities will offer a 0.2% discount on guarantee fees for credit guarantee loans from the Korea Credit Guarantee Fund for hospitals and pharmacies participating in claim computerization for five years from Jan. 2026.
Participating healthcare institutions will receive substantial financial incentives, including a 3-5% discount on general insurance premiums starting from Nov. 2025.
EMRs participating in claim computerization will be granted a Silson24-linked certificate; computerized claim services will be accessible via EMR apps for patients.
SK FSC will come up with measures in collaboration with SK MOHW to encourage medical institutions and EMR firms to participate in claim computerization.
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.
Oct. 2024 Computerization Launch Event
On Oct. 25, 2024, SK FSC, SK FSS hosted claim computerization launch event.
Published releases cover participation status, notable comments, and future plans.
Will strengthen communication with hospitals and EMR firms not yet participating and continue to expand participation; for hospitals that have confirmed participation, actively pursue the goal of linking the Silson24 app and the hospital before end-2024.
In addition, the Insurance Development Institute plans to operate a Silson24 status room to check the system status in real time and take immediate action re any issues.
Sep. 2025 Improvement Measures
On Sep. 5, 2025, SK FSC held an actual loss insurance computer system operation committee meeting to decide on basic matters re its composition and operation.
To discuss plans to facilitate the computerization of actual loss insurance claims, ahead of the second-phase implementation with clinics and pharmacies from Oct. 25, 2025.
SK FSC will induce consumers to directly request electronic transmission of insurance claim documents from medical institutions by improving service effectiveness.
To this end, Silson24 will be actively linked to online platform services; consumers who file insurance claims via Silson24 will be given cashback points from online platforms.
Insurers will expedite payment within 24 hours for outpatient claims under KRW 300k made via Silson24 which do not require review; Silson24 services will be improved by simplifying identity verification and developing a document supplementation function.
Financial authorities and related entities will offer a 0.2% discount on guarantee fees for credit guarantee loans from the Korea Credit Guarantee Fund for hospitals and pharmacies participating in claim computerization for five years from Jan. 2026.
Participating healthcare institutions will receive substantial financial incentives, including a 3-5% discount on general insurance premiums starting from Nov. 2025.
EMRs participating in claim computerization will be granted a Silson24-linked certificate; computerized claim services will be accessible via EMR apps for patients.
SK FSC will come up with measures in collaboration with SK MOHW to encourage medical institutions and EMR firms to participate in claim computerization.
Regulators
SK FSC
Entity Types
Ins
Reference
Mt, PR, 9/5/2025; PR, Mt, 10/25/2024; Mt, DB, PR, 9/12/2024; CP, Nt 2024-64, PR, 3/5/2024; Dec 34083, 12/29/2023; Law 19780, 10/24/2023;
