2024-07-29 14:32:30
I pay my insurance premiums every year, but if I have a car accident, I am treated like a ‘nylon patient’
Last year, 25 million vehicles were required to have car insurance… The majority of subscribers who did not have accidents paid their insurance premiums to the insurance company
While some insurance companies are claiming that the reason for the increase in automobile insurance loss rates is due to oriental medicine treatment, the Korean Association of Oriental Medicine Hospitals has claimed that this is not true.
According to the Korea Insurance Development Institute, the average number of ‘auto insurance patients who received treatment exceeding the liability insurance limit’ over the past five years since 2019 was 47.4%. Last year, it was 46.4%.
In order to improve the so-called ‘nylon patient’ problem, the government strengthened the standards for payment of medical expenses for patients with minor injuries since January of last year. Patients with minor injuries are required to pay for the portion of their medical expenses that is attributable to their own fault through their own insurance or out of their own pocket, and patients with minor injuries are required to submit a medical certificate every two weeks if they receive treatment for more than four weeks.
Car insurance is mandatory for all drivers. Some car accident patients have complained, saying, “When there are signs that the treatment period will be extended, insurance companies try to persuade us to settle,” and “It feels like they are treating me like a nylon patient.”
As of last year, the number of automobile insurance subscribers exceeded 25 million, and 1.63 million of them received oriental medicine treatment due to traffic accidents. The Korean Oriental Medicine Hospital Association claimed, “Insurance companies claim that the increase in automobile insurance loss ratios is due to oriental medicine treatment as if they would go bankrupt at any moment, but in reality, the majority of insurance premiums from people who did not have an accident are going into the pockets of insurance companies.”
Last year, auto insurance sales increased by KRW 281 billion from the previous year (KRW 20.7674 trillion) to KRW 21.484 trillion. In addition, the auto insurance profits and losses of insurance companies last year increased by KRW 75.9 billion from the previous year (KRW 478 billion) to KRW 553.9 billion, maintaining a surplus for three consecutive years since 2021.
The automobile insurance loss ratio is also showing a downward trend. The automobile insurance loss ratio, which was 92.9% in 2019, recorded 85.7% in 2020, 81.5% in 2021, 81.2% in 2022, and 80.7% in 2023.
The Korean Oriental Hospital Association recently cited the ‘characteristics of the automobile insurance system, which has a wider coverage range than health insurance,’ and the ‘effectiveness of oriental medicine treatment specializing in musculoskeletal treatment’ as fundamental reasons for the increase in oriental medicine treatment costs.
Also, regarding the claim that the annual average increase in the cost of oriental medicine treatment for non-covered items has been close to 10% over the past five years and that the increase in herbal acupuncture and herbal medicine is notable, it was argued that this is because the effect of oriental medicine treatment felt by patients is great. A study reported that herbal acupuncture treatment for back pain improves six times faster than physical therapy. When patients with the aftereffects of traffic accidents were divided into a group treated with herbal medicine and a control group that was not prescribed herbal medicine and analyzed for treatment effects, it was found that the group treated with herbal medicine showed greater improvement in the aftereffects of traffic accidents and the level of stress after the accident than the control group.
The association claims that there are no detailed review guidelines for oriental medicine treatment costs, but it mentioned that the fees for non-covered oriental medicine treatments such as herbal medicine and acupuncture have been controlled for a long time and the review criteria are becoming increasingly detailed. In April, the Ministry of Land, Infrastructure and Transport announced the creation of a data submission system for herbal medicine and acupuncture. In fact, very specific review criteria are applied to patients with minor injuries, such as the number of days of herbal medicine prescriptions and the number of times herbal medicine is administered. It argued that it is very natural in actual clinical practice to prescribe drugs and procedures with different efficacies in combination.
An official from the Korean Oriental Hospital Association said, “In the case of oriental medicine treatment under health insurance, accessibility is low due to the low coverage and non-application of actual loss insurance for non-covered procedures, which places a large financial burden on patients.” “However, since the coverage environment for oriental medicine treatment and medical treatment is the same for automobile insurance, many patients who have experienced the effects of oriental medicine treatment are choosing oriental medicine medical institutions, which is increasing the related treatment costs.” He continued, “However, it is not right to mislead people into thinking that oriental medicine hospitals are continuing to provide excessive treatment by linking this to things like set treatment.”
Reporter Hong Eun-sim [email protected]
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2024-07-29 14:32:30