사진 확대

As the number of times has been limited due to manual treatment management benefits since last month, the amount of actual loss insurance claims filed with insurance companies has decreased. As claims for non-payment treatment such as manual treatment, which has been considered a major cause of the leakage of loss insurance due to over-treatment, have decreased, attention is being paid to whether there will be practical effects and changes such as a decrease in the premium increase in the future.

According to the insurance industry on the 13th, the amount charged to insurance companies is decreasing due to the limit on the number of manual treatments that have been guaranteed by loss. However, as the number of manual treatment has decreased, there is an opinion that the long-term effect should be seen over time as kidney injection treatment, which is a non-payment treatment with similar treatment purposes, increases. Kidney injection therapy is a non-payment physical therapy that relieves pain by spraying cooling energy briefly on the pain area.

Manual treatment, which was a representative non-payment treatment, has been incorporated into health insurance since last month through management benefits, and the cost of treatment per time will be 43,850 won, twice a week, and 15 times a year. Exceptionally, it is recognized up to 24 times a year, depending on the judgment of the doctor. The patient pays 95% of the cost and the health insurance guarantees 5%. However, existing 1st to 4th generation loss subscribers can be guaranteed through loss, but there is a limit on the number of times per year.

In addition, guidelines for external shock, which had a high frequency of treatment, were also created along with manual treatment. In vitro shock wave treatment was limited to a maximum of 6 times per site and a maximum of 12 times per year, and applicable diseases and treatment sites were also determined. As the number of non-benefit treatments has been limited, the amount of related claims has been decreasing at major non-life insurers this year.

사진 확대

Samsung Fire & Marine Insurance said at the second quarter earnings conference call held on the same day that the daily average of KRW 450 million in the first half of this year was about KRW 100 million as of this month. Compared to the first half of the year, the average daily claim is reduced by about 78%.

Meritz Fire & Marine Insurance also announced at a conference call on the previous day that the average daily claim per receipt decreased from 130,000 won to 40,000 won after manual treatment management benefits were implemented. In addition, he pointed out that in vitro shock wave treatment, which was discussed as an over-treatment along with manual treatment, is also decreasing.

However, the industry believes that the recent decrease in claims does not directly lead to an improvement in the loss ratio of actual losses. This is because it is effective in the stable operation of loss rather than improving the loss ratio immediately as the deficit of loss accumulated by making a deficit of 1 to 2 trillion won every year. In addition, it is also necessary to look at the increasing trend of non-payment treatment to replace manual treatment such as kidney injection treatment.

In this regard, the industry is positive that over-medical treatment has recently decreased, but the improvement of the loss of loss should be viewed from a long-term perspective. As loss is actually an essential insurance and guarantees hospital treatment and treatment rights in everyday life, it is necessary to reduce the leakage of insurance money for operation sustainability.

An industry official said, "As it has been more than a month since the system was implemented, we will need to look at the balloon effect of similar non-payment treatment rather than the immediate effect," adding, "Since loss is a nature of essential insurance, reducing the leakage of insurance money may have the effect of subscribers feeling it, but the accumulated deficit improvement is a priority."