When some private insurance companies pointed out that the calculation of medical expenses for medical institutions was unreasonable or excessive, and requested the preparation of an implementation agreement that promises to perform appropriate treatment in the future, the medical community was fiercely opposed.
In a statement on the 12th, the Korean Medical Association urged, “Insurance companies should immediately stop the tyranny of insurance companies trying to transfer responsibility for designing insurance products to medical institutions.” did.
The medical association said, “If you look at the contents of the implementation agreement, medical institutions are required to self-confidence that some amounts violate the relevant laws in the process of calculating the patient’s medical expenses, and to commit to appropriate medical treatment and compliance with related laws and regulations. If submitted, it is judged that we will reserve the immediate return request procedure for the part that has been acknowledged.”
However, since the treatment for the patient is made 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 judgment of the appropriateness is one-sided by private insurance companies seeking to maximize profits by minimizing insurance payments. It is the opinion of the KMA that it should not be decided from a human perspective.
In a situation where private insurers are putting pressure on medical institutions by filing criminal prosecutions and civil lawsuits due to excessive medical treatment and unfair claims, having medical institutions admit mistakes and write agreements can lead to prosecution and lawsuits against the case. It puts pressure on the possibility of avoiding the situation, which is a coercive behavior and unfair tyranny of a giant private insurance company
In this regard, the KMA urged, “We demand an immediate cessation of requests for private insurance companies to prepare implementation agreements for medical institutions,” and urged, “The Financial Supervisory Service should take appropriate guidance and supervision for such overbearing behaviors of insurance companies.”
“It is unacceptable to pass on to medical institutions the problem of excessive expenditure of insurance money resulting from excessive competition between insurance companies and the establishment of special contracts and the resulting loss ratio increase to medical institutions. He advised that it is the right direction to ask for cooperation from subscribers and the medical community while leading the way.”