As the implementation of the so-called '8-week rule' for auto insurance claims approaches next month, the property and casualty insurance industry is ramping up preparations. Insurers are developing a review system and refining compensation procedures, while the Korea Automobile Injury Compensation System (KAIC) has begun establishing a medical review committee to assess the necessity of continued treatment.
According to the insurance industry on August 6, insurers are creating a computerized system that incorporates the review process for additional treatments, along with updating internal guidelines.
Under the new system, patients classified with injury grades 12 to 14 who seek treatment beyond eight weeks after an accident will need to submit a medical certificate, copies of medical records, and imaging data to their insurance company. The insurer will then forward this information to the KAIC, which will evaluate the necessity for extended treatment through a panel of medical professionals and communicate the results to both the insurer and the patient. Consequently, insurers are establishing a new review request function that was not part of the previous compensation system.
The KAIC is also accelerating its preparations for the review system. It is forming a medical review committee consisting of approximately 200 specialists in Western and traditional medicine, while also working to secure medical and administrative personnel to support the review process. Although recruitment for related personnel began in April, the process was halted due to a delay in the system's implementation. With the schedule now confirmed, preparations are resuming.
However, some experts predict that the new system may not immediately lead to a reduction in the workload for insurers. Initially, it was expected that unnecessary long-term treatments would decrease, thereby reducing both loss ratios and compensation work. In reality, new tasks such as guiding patients through additional treatment requests, processing review applications, exchanging data with the KAIC, notifying about review results, and handling complaints will be added.
An official from one insurance company stated, “Previously, the focus of compensation work was on concluding treatment and reaching agreements. Now, we will have to guide customers through the additional treatment review process and exchange results with the KAIC. While we agree with the intent of the system, we anticipate that initial implementation may lead to more confusion and a heavier workload than expected.”
Concerns about a balloon effect have also been raised. Since patients can receive treatment without a separate review up to eight weeks, there is a possibility that some may seek intensive treatment or focus on specific medical services before becoming subject to review. Critics have pointed out that while the new system aims to assess the appropriateness of treatment duration, it has limitations in managing the content of the treatment itself.
* This article has been translated by AI.
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