Insurers Mandated to Disclose Reimbursement Claim Data and Payout Standards Quarterly

The Financial Supervisory Service (FSS) has established new regulations requiring insurers to disclose the status of customer reimbursement insurance claims and changes in payout standards every three months. This measure is intended to reduce disputes and complaints related to insurance payouts, coinciding with the launch of the fifth-generation reimbursement insurance product.

Under the revised rules, insurers must analyze and disclose claim trends and detailed causes of disputes for each treatment item that frequently experiences claims or a surge in disputes on a quarterly basis. Insurers are required to provide this analysis to consumers at the time of contract signing, premium renewal, or claim filing, or post it on their website. Information on the claim review process and potential risks such as over-treatment will also be explained.

The Financial Services Commission and the FSS plan to initially introduce this disclosure obligation for reimbursement insurance and gradually expand it to other insurance products, such as fixed-sum insurance, in the future.