Increased loss ratio through excessive competition Transfer of responsibility to medical institutions
Urging the Financial Supervisory Service to guide and supervise the overbearing behavior of insurance companies
“Immediately halting the request for an implementation agreement that puts only the profits of private insurance companies ahead”
Recently, it was confirmed that some private insurance companies claimed that the medical expenses were unfairly or excessively calculated, and requested medical institutions to acknowledge the facts and to write an implementation agreement to ensure appropriate treatment in the future. The Korean Medical Association said in a statement on the 12th to immediately stop the tyranny. Urged.
The implementation agreement contains the contents of self-acknowledgement of violations of the laws of medical institutions in the process of calculating patient medical expenses, and to ensure appropriate medical treatment and compliance with related laws and regulations. It is interpreted as a means of deferring the immediate return request procedure for the fact-recognized part by filling out and submitting the document.
This means that the insurance company will determine the appropriateness of medical judgment and treatment method selection according to the patient’s request.
The medical association said, “Because medical treatment for a patient is performed at the request of the patient and the selection of an appropriate treatment method according to the medical judgment of the patient’s disease, the appropriateness of the decision is made by private insurance companies seeking to maximize profits by minimizing insurance payments. It should not be judged from a one-sided point of view.”
In a situation where insurance companies are prosecuting civil and criminal lawsuits, they also condemned the wrongdoing of pressing medical institutions under the guise of this.
The medical association said, “In a situation where a private insurer is filing criminal prosecution or civil lawsuits for excessive medical treatment or unfair claims, etc., it is necessary to impose pressure on medical institutions to avoid the prosecution and litigation situation if the agreement is written. As a result, he criticized that it was an overbearing behavior and unfair tyranny of a giant private insurance company.”
In addition, it is judged that the problem of excessive insurance spending and an increase in loss ratio resulting from excessive competition by insurance companies will be passed on to medical institutions.
The medical association said, “It is unacceptable to pass on the problem of excessive expenditure of insurance money resulting from excessive competition between insurance companies and the establishment of special contracts and the resulting increase in loss ratio to medical institutions.” “It is the right direction to ask for cooperation from subscribers and the medical community while leading the way.”
It also urged private insurance companies to be self-determined and supervised by the Financial Supervisory Service.
The medical association “requires an immediate cessation of the request for a private insurance company to prepare an implementation agreement, and the Financial Supervisory Service requests that the insurer take appropriate guidance and supervision on such overbearing behavior.” Insurers strongly demand an immediate stop against the tyranny of transferring responsibility for product design to medical institutions.”
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