<Anchor> This is a
friendly economic time. Today (the 20th) we will also be with reporter Han Ji-yeon. Do you think the insurance premium will go up quite a bit next year?
<Reporter>
Yes, there is a saying that indemnity insurance is beneficial if you buy it. To those who are about to renew the indemnity insurance, you must have received it. A notice has been sent to raise your premium by up to 20%.
This is because the original insurance company must notify you 15 days in advance when the insurance company intends to raise the premium. So, it can be considered that the notification has already been made. The exact width of the impression has not yet been determined.
A notice will come back once the insurer and the financial authorities have coordinated and decided on it. However, the possibility of a 20% increase does not seem high.
As the presidential election is approaching, it seems difficult for the financial authorities to receive the proposals offered by insurance companies as they are. Also, there are now over 39 million indemnity insurance subscribers.
It can be said that it is the second health insurance, but if you raise it this much, inflation pressure will increase immediately. Therefore, the tug-of-war between insurance companies and financial authorities is likely to continue until the end of the year.
<Anchor>
Why are insurance companies raising premiums like this?
<Reporter>
The reason for the serious loss of indemnity insurance is that it was 2.3 trillion won last year, but this year it will exceed 3 trillion won. In 10 years, it is expected to reach 22 trillion won.
So, how much did you get paid and how much did you give out? What this means is that if the insured pays 1 million won in insurance premium, the insurance company pays 1.31 million won.
Therefore, in order to avoid the loss of indemnity insurance, premiums must be raised by 19.3% every year until 2031. There is also such an analysis, and if this happens, the subscriber burden will inevitably increase.
<Anchor> As
I just said, it is a problem for some insurers to receive excessive insurance money, but there is also a story that indemnity insurance itself is a loss structure.
<Reporter> If
you look at this situation, it can be said that the insurance company caused this situation.
Prior to 2009, those who suffered a loss had no deductible at all. It's still around 10-20%.
In addition, indemnity insurance is covered because of non-insurance items that are not covered by medical insurance.
In this way, the indemnity insurance structure is inherently negative. But now I am passing this on to the consumer, which is why I have been criticized for it. In addition, the problem of excessive treatment of uninsured items in the medical industry continues to be raised.
Another problem is that a small number of insured people take most of the insurance money. If you look at the table, 62.4%, or 2 out of 3 people, do not receive insurance at all.
However, 0.3% of them are taking more than 50 million won, and about 2.2% are taking more than 10 million won, which can be seen as quite distorted.
<Anchor>
Another thing we should look into is insurance fraud. Are you saying that there has been a recent report on insurance fraud?
<Reporter> A
joint investigation council was formed at the beginning of this year to catch such insurance fraud. Last year alone, 25 medical institutions committed 23.3 billion won in insurance fraud.
You've already spent a lot of money on your indemnity insurance because of manual treatment. The amount doubled in two years, and when I looked at why it had increased so rapidly, there were cases where, in addition to pediatrics, dermatology, obstetrics and gynecology, even dentists were charged.
In another case, when I looked at the hospital where insurance claims were made, it was said that there were no wards at all, as it is a so-called 'office office hospital' operated by non-medical personnel.
The most common type of insurance fraud was manipulating the name or contents of the treatment.
False hospitalizations and false diagnoses followed.
Indemnity insurance was the most frequently used product for fraud.
I got insurance by inflating the number of outpatient visits or issuing fake medical certificates or receipts for medical expenses, but the amount caught was close to 70% of the total.