Billions Lost, Millions Gained: The Surprising Solution 40 Million People Are Flocking To
- Simplification of actual cost insurance claims in full effectClaim ‘Silloss 24’ app without having to take out documents at the hospitalImplemented for hospitals and public health centers with...
- “I think it’s very difficult for my parents to file an insurance claim for actual loss.
- The ‘Simplification of Actual Loss Insurance Claims’ service, which eliminates the hassle of patients with actual loss insurance having to manually submit documents to file an insurance claim,...
Simplification of actual cost insurance claims in full effect
Claim ‘Silloss 24’ app without having to take out documents at the hospital
Implemented for hospitals and public health centers with more than 30 beds
Agency billing/simultaneous billing from multiple insurance companies possible
“I think it’s very difficult for my parents to file an insurance claim for actual loss. When I asked the hospital’s general affairs department what kind of documents I needed to obtain, they just told me that ‘each insurance company is different’ and that I had to find out for myself… In times like that, it seems like they just put off filing an insurance claim.” (Mr. Kim, in his 40s)
The ‘Simplification of Actual Loss Insurance Claims’ service, which eliminates the hassle of patients with actual loss insurance having to manually submit documents to file an insurance claim, went into effect on the 25th of this month.
When a consumer requests to receive actual loss insurance money at the hospital, documents are sent to the insurance company and the hospital claims the insurance money right away. Claiming insurance money, which had previously been a hassle and had been given up, has become much easier.
An insurance industry official said, “As of the end of 2022, about 40 million people have signed up for actual loss insurance, so it is also called the ‘second national health insurance.’ He explained, “At least 100 million insurance claims are made every year,” and “However, there are quite a lot of insurance payments that have not been claimed by actual loss subscribers, which are estimated at 255.9 billion won in 2021, 251.2 billion won in 2022, and 321.1 billion won in 2023.”
To use the billing simplification service, first log in to the ‘Silloss 24’ app, view and select the insurance contract, select the hospital, treatment date and details, and then create a claim. You can send major documents such as bills, receipts, detailed calculation of medical expenses, and prescriptions.
Hospitals and public health centers with more than 30 beds will be able to file claims for actual loss insurance starting this month, and clinics and pharmacies with less than 30 beds will be able to file claims for actual loss insurance starting October 25 next year.
As of the 24th of this month, 4,223 of the 7,725 target institutions have confirmed participation in the computerization of actual cost insurance claims, and it is disappointing that the participation rate is 54.7%.
About a year has passed since the amendment to the Insurance Business Act passed the threshold of the National Assembly and preparations were made for the introduction of the system, but the situation has become ‘departure with the car door open’.
Accordingly, the financial authorities strengthened communication with non-participating hospitals to encourage participation, and ordered the insurance industry to begin persuading local clinics and pharmacies to participate as early as October next year.
![[사진 = 뉴스1]](https://i0.wp.com/pimg.mk.co.kr/news/cms/202410/26/news-p.v1.20241025.5cb0bb719c7d44a4bb37fb3080036435_P1.jpg?ssl=1 "Billions Lost, Millions Gained: The Surprising Solution 40 Million People Are Flocking To")
enlarge photo [사진 = 뉴스1] If it is difficult to write an insurance claim yourself, you can also file a claim on your behalf.
Representative claims can be made by parents, grandparents, children, siblings, spouse, and third parties. Additionally, if you have purchased actual loss insurance from multiple insurance companies, you can file claims at the same time.
There are also some things to watch out for. The information that you can file an insurance claim at the hospital where you received treatment is incorrect.
Basically, since the person making the insurance claim is the subscriber, the claim must be made directly through the Silloss 24 app or website, not through the hospital.
The important thing here is whether the hospital can use the billing simplification service. In other words, claims can only be made to hospitals linked to the Silloss 24 service.
You can search for medical institutions that can make electronic claims on the Silson 24 app or website. In addition, linking with smartphone map apps is also being promoted.
Lee Bok-hyeon, the head of the Financial Supervisory Service, said, “The costs saved by simplifying actual loss insurance claims, and the benefits, such as reduced insurance premiums, should go directly to the people,” adding, “Furthermore, the actual loss claim computer system must be meticulous and stable as personal sensitive information is transmitted.” “It has to be operated,” he emphasized.