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We have told several times that an increasing number of people believe in the hospital saying that there is loss of life insurance and have cataract surgery, but are not receiving money from the insurance company.

As people's complaints poured in, the Financial Supervisory Service, which is responsible for managing and supervising insurance companies, also stepped in late, but no clear guidelines have been issued yet.



This content was covered by reporter Jeon Yeon-nam.



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Mr. A, who had cataract surgery three months ago, requested the insurance company for the operation fee, but was rejected.



He said the reason was that when he showed his medical records to a doctor appointed by the insurance company, it was difficult to ascertain whether the purpose of treatment was correct.



[Mr. A: I won't be able to tell you what the doctor's real name is. (Then) Let's go to a hospital you don't know and I don't know.

(The insurance company has not contacted me yet.]



The Financial Supervisory Service played a major role in the insurers' refusal to pay insurance claims using medical advice as a weapon.



In April, the Financial Supervisory Service issued a guideline that insurance companies can refuse to pay after consulting medical advice if they have any doubts.



In response, insurance companies have refused to pay insurance benefits, interpreting the opinions of the advisors that it is difficult to judge them.



[Mr A: 'If you want to raise an objection, file a complaint with the Financial Supervisory Service'.

That means (insurance company) has the FSS on its back.

No matter what you do, the FSS is on our side.]



Over 8,000 subscribers' complaints poured into the transition committee's website.



Then, at the end of last month, the FSS sent an official letter to insurance companies not to abuse medical advice and put the brakes on it belatedly.



Today (2nd), even the insurance company executives gathered to discuss countermeasures, but only showed an ambiguous attitude.



[Financial Supervisory Service official: After all, we are an administrative agency.

If you are not satisfied with the settlement of disputes (insurance companies and subscribers) resolve them through civil litigation.]



As consumer damage has already snowballed and further damage can occur, the authorities need to provide clear guidelines.



(Video editing: Kim Jong-mi, VJ: Park Hyun-woo)