“With what authority does private real-life insurance company require medical institutions to sign a’implementation agreement’? They seem to know what kind of judicial institution they are. Even a judicial or quasi-judicial institution cannot make such a request without a legal basis. Furthermore, it is unacceptable that private companies for real-life insurance are pressured by medical institutions without any legal basis.”
No. 6 candidate Kim Dong-seok, who ran for the 41st presidential election of the Korean Medical Association, pointed out on the 12th, “The tyranny of indemnity insurers is overrun.”
Recently, certain insurance company employees have come to medical institutions and demanded to write a’implementation agreement’ that demands that they be careful not to overestimate unpaid benefits.
It was found that ▲ the prevention of unfair medical care benefit expenses ▲ accurate and fair preparation of medical records, details of medical expenses, receipts, etc. ▲ compliance with related laws such as the Medical Law and the National Health Insurance Law, etc.
Candidate Kim said, “The dispute over indemnity insurance is a problem between the insurer and the insured, and has nothing to do with medical institutions. The medical institution does not know that the insurance company is asking the subscribers to pay the bill, but why is it to the third-party medical institution?”
Candidate Kim said, “Medical institutions are concerned about various damages due to the abuse of the’Special Act on the Prevention of Insurance Frauds’ to prevent insurers from paying insurance payments. The concern about whether it can be exploited is a reasonable doubt.”
According to the law, insurance companies are required to report to the Financial Services Commission if there is a reasonable basis for suspicion of insurance fraud in relation to insurance claims related to loss, etc., and to make a complaint or request to an investigative agency.
Candidate Kim said, “I filed a complaint with the Financial Supervisory Service when all insurers had pressed the cost of opening the cost, saying that insurance payments could be denied for uncovered treatment. “We received an answer from the insurance company that’non-indemnity treatment such as the administration of nutrients is subject to medical judgment.'”
He emphasized, “We are seriously warned that private insurance companies with loss of losses may be held legally liable if they do not stop such tyranny.”