Living in Korea and insurance
What documents do you need for an insurance claim?
The same documents are not required for every claim. The list depends on whether the treatment was outpatient or inpatient, whether the event was an illness, injury or motor accident, and the amount claimed.
Documents commonly used for a medical-expense insurance claim include:
- the insurer’s claim form and privacy-related consent;
- proof of the claimant’s identity;
- an itemised medical bill or official receipt;
- a detailed statement of medical charges when required;
- a prescription; and
- documents showing the treatment, such as a medical certificate, treatment confirmation or hospital admission and discharge confirmation.
A small outpatient claim may require relatively simple documents. If the amount is larger or the treatment information does not make coverage clear, the insurer may ask for additional material showing the diagnosis, disease-classification code or treatment period. Depending on the insured event, it may also require evidence of family relationship, authority to act, bank-account details or the accident itself.
Some claim documents can be transmitted electronically by medical providers connected to 실손24. Not every provider is connected, and the insurer may still request additional information to assess the claim after an electronic submission.
When receiving documents, check that your name, date of treatment, medical provider and amount are correct. Some documents may be difficult to reissue, so obtain what you need before leaving Korea. Ask the insurer whether originals are required or whether photographs or scans are accepted.
What “standard documents” means
The General Insurance Association of Korea publishes standardisation guidance for medical-expense claim documents. This does not mean that additional documents can never be requested. An insurer may seek reasonably necessary information to decide whether the event is covered.
Checklist for foreign residents
- Explain in advance if the English name on the policy differs from the name on the medical document.
- If you will submit from abroad, ask first whether translation, originals or authentication are required.
- Medical certificates and detailed treatment records contain sensitive information; send them only through the insurer’s official channel.
- Do not attach medical documents to an informal messenger conversation or general inquiry form.