Korea's Top 5 Insurers Pay 8.5 Trillion Won in Health Claims in Jan-Sept

Korea's five largest non-life insurers paid out 8.5 trillion won ($6.3 billion) in indemnity health insurance claims in the first nine months of this year, with orthopedic treatments including manual therapy and extracorporeal shockwave therapy accounting for the largest share.

The five major non-life insurers—Samsung Fire & Marine Insurance (000810.KS), DB Insurance (005830.KS), Hyundai Marine & Fire Insurance (001450.KS), KB Insurance (002550.KS), and Meritz Fire & Marine Insurance (000060.KS)—paid 8.4848 trillion won in indemnity health insurance claims from January to September, up 13.1% from the same period last year, according to financial industry sources on Sunday.

Indemnity health insurance payouts grew at an average annual rate of 7.6% from 2021 through last year, but the increase has accelerated this year.

By medical specialty, orthopedics accounted for 1.8906 trillion won, or 22.3% of total payouts, ranking overwhelmingly first among 29 specialties. Non-covered treatments represented 70.4% of orthopedic payouts, far exceeding the average of 57.1%. The high proportion of non-covered treatments is attributed to the concentration of non-covered physical therapies such as manual therapy and extracorporeal shockwave therapy.

Excessive use of non-covered physical therapies and injections has been identified as a major cause of indemnity insurance leakage. According to the Korea Insurance Research Institute, of the 12.9 trillion won in total insurance payouts by non-life insurers last year, physical therapies including manual therapy, extracorporeal shockwave therapy, and prolotherapy accounted for 2.2903 trillion won, while non-covered injections totaled 652.5 billion won. Together, these represent about 23% of total insurance payouts.

Meanwhile, insurance premiums for delivery riders will drop by up to 30% starting in the first quarter of next year. The Financial Supervisory Service has decided to lower the eligibility age for hourly insurance for delivery motorcycles from 24 years or older to 21 years or older. Insurers have also agreed to reduce premiums for delivery riders' personal injury coverage by 20-30% from current levels by utilizing statistics from all insurance sectors in the premium calculation process. As of the end of October, the average insurance premium per delivery motorcycle stood at 1.03 million won, six times higher than the 179,000 won for personal-use motorcycles, prompting strong demands from riders for rate reductions.