South Korean insurers denied payouts in 85.8% of all insurance-related damage relief filings received during 2025, according to an analysis released recently by the Korea Consumer Agency.
The analysis released on 08 June 2026 reveals that insurance-related damage relief filings have continued to rise since 2021. Also, the analysis found that cases in which insurers refused to recognise treatments or demanded medical consultations to reject payouts have increased in tandem.
The KCA received 930 insurance-related damage relief filings in 2025 and 85.8% (798 cases) were related to insurers refusing to pay the benefits. The most common reason for denying payouts was "non-recognition of the attending physician's diagnosis or treatment," accounting for 67.4% (538 cases). This was followed by "disagreement over policy terms" at 20.7% (165 cases) and "disagreement over loss amounts" at 9% (72 cases).
Insurance-related damage relief filings in South Korea are official complaints filed by policyholders with agencies like KCA to resolve disputes over denied or underpaid claims. These filings primarily address rejections by insurers of payouts based on a physician's diagnosis.
According to KCA, the General Insurance Association and the Life Insurance Association established and have operated "medical consultation internal control standards" since August 2021 to prevent medical consultations from being abused as a means of denying insurance payouts. However, improvement is needed because there are effectively no restrictions on the targets subject to medical consultation.
KCA in its release said, "Based on this analysis, we plan to ask the General Insurance Association and the Life Insurance Association to improve the 'medical consultation internal control standards' to prevent harm to consumers caused by insurers' unnecessary medical consultation demands.”
The agency has also asked the consumers to check in advance their insurer's payout review criteria when availing treatments that are not specifically covered by their insurers. It has also suggested that they should submit a detailed explanation of the reason for the medical consultation and the contents of the inquiry when an insurer demands one; and to request a re-examination if they object to the medical consultation results.