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Editorial: Editorial.Column: News: Hankyoreh

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financial committee. <한겨레> data photo

Insurance premiums for indemnity insurance with more than 35 million subscribers will rise sharply next year as well. This is upsetting for subscribers who don’t get much hospital care. This is because the moral hazard of hospitals that promote ‘excessive care’ and the moral hazard of some insurers who take so-called ‘medical shopping’ insignificantly soars even the premiums of good subscribers. The insurance companies that made troublesome insurance products and rushed to attract subscribers and the financial supervisory authorities who approved them must reflect painfully. Insurance companies requested the financial authorities to raise premiums for both the first-generation indemnity insurance sold until September 2009 and the second-generation indemnity insurance sold until March 2017 by 25% next year. In response, the Financial Services Commission made an opinion on the 27th to lower the increase to 60%, and the industry accepted it. As a result, first and second-generation insurance rose by an average of 15% on average, and third-generation insurance sold after April 2017 increased by an average of 8.9%. The rate of increase for insurers who have reached the point of renewal every 3-5 years will reach around 50%. In real-life insurance, the high loss ratio (the ratio of premiums to premiums) has become a problem. In the case of the first-generation loss, 100% of self-payment was guaranteed, which was abused by some hospitals to induce overtreatment and some subscribers to accept it. Although the authorities have been improving with 2nd, 3rd, and 4th generation insurance, which increases self-pay and lowers premiums, 17.31 million people have already subscribed to 1st and 2nd generation insurance. The older the insurance, the higher the loss ratio, which is why premiums continue to rise sharply. The 4th generation indemnity insurance, which started selling in July, introduced several devices to prevent moral hazard. The insured must pay 20% of the medical expenses for covered items and 30% for non-covered items. Insurance premiums are also discounted or increased according to the details of medical bills. As of 2018, 90.5% of indemnity insurance policyholders never made a claim. Insurance companies should actively compensate such insurers with special premium discounts, etc. when they switch to 4G insurance. In the future, the financial supervisory authority should not easily tolerate the increase in insurance premiums and let the insurers find a solution themselves. Excessive treatment by hospitals for indemnity insurance subscribers is also immoral in that it erodes the finances of health insurance. The financial supervisory authority should work more actively with related ministries such as the Ministry of Health and Welfare and the Health Insurance Corporation to find ways to control and block excess treatment.

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