SK FSS Non-Insured Benefit Payment

On Jan. 19, SK FSS issued a plan for benefit payment inquiry system.

  • SK FSS issued a plan to establish a payment inquiry system for non-insured benefits.
  • Background
  • SK FSS will implement the differentiated insurance premium system for non-insured medical services from Jul. 2024, which reduces/raises insurance premiums for non-insured medical services, by classifying 5 grades according to paid insurance amounts.
  • Aims to stabilize indemnity insurance premiums by improving fairness of premium burden among policyholders, reducing unnecessary use of non-insured services.
  • Inquiry System
  • Aims to enable consumers to reasonably manage their use of non-insured medical services, to prepare for implementation of differentiated insurance premium system.
  • 4th generation indemnity insurance subscribers can check premium discounts, surcharges for non-insured services via insurance companies' websites/apps.
  • Also check for accumulated insurance payments for non-insured items, remaining insurance amount for non-insured items before reaching the next stage of premium surcharges, required application documents for exclusion from discounts/surcharges.
  • Plan
  • SK FSS will implement the revised Detailed regulations on supervision of insurance business in Apr. 2024, in order to introduce the inquiry system slated for May 2024.
  • Promote institutional improvements re the implementation of the differentiated insurance premium system and the non-insured benefit payment inquiry system.
  • In Feb. 2024, SK FSS proposed revisions to insurance business rules, see #200699.

Regulators SK FSS
Entity Types CNSM; Ins
Reference PR 1/19/2024; Reg 12/21/2023
Functions Actuarial and Valuation; Claims/Accelerated Benefits; Compliance; Financial; Legal
Countries South Korea
Products Insurance; Insurance-Health
Regions AP
Rule Type Final
Rule Date 1/19/2024
Effective Date 5/1/2024
Rule Id 198485
Linked to Rule :200699
Reg. Last Update 1/19/2024
Report Section International

Last substantive update on 01/23/2024