Financial Authorities Scrutinize Cancer Immunization Enhancement Claims Amid Rising Healthcare costs
SEOUL, SOUTH KOREA – South Korean financial authorities are increasing oversight of cancer immunization enhancement prescriptions and related insurance claims, citing concerns over possibly unnecessary treatments and escalating healthcare costs. The move comes as reports surface of medical institutions allegedly exaggerating the benefits of non-covered immunization enhancements, and in certain specific cases, refusing hospitalization to patients who decline costly, unproven treatments.
The escalating situation threatens to exacerbate already strained relationships between insurers and policyholders, particularly as loss insurance rates continue to deteriorate. The third generation of loss insurance recorded a loss rate of 155.3% in 2023, remaining around 150% in the first half of 2024. Newer, fourth-generation loss insurance is also experiencing rising loss rates, reaching 131.4% in the first half of last year. These figures highlight a growing financial burden on the insurance industry, prompting calls for regulatory intervention.
Financial authorities recently instructed insurers to prioritize “consumer protection in terms of cancer immunization enhancement benefits,” signaling a proactive approach to address potential abuses. This guidance follows concerns that some medical facilities may be utilizing U.S.-based medical technologies – frequently enough not fully covered by insurance - as a revenue source, potentially leading to unnecessary procedures.
The insurance industry has welcomed the administrative guidance,but is also advocating for revisions to standard loss insurance terms and conditions. An industry official stated that the lack of clarity surrounding the side effects and efficacy of these emerging medical technologies necessitates a comprehensive review. ”If medical institutions use US-based medical technology as a means of revenue, unnecessary treatment will increase and construction insurance fiscal soundness will be deteriorated,” the official said, urging the authorities to retroactively examine existing policies.Hong Chang-ki, ThevyFirst@fnnews.com
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