Elise explains insuranceClear guidance on insurance in Korea

Living in Korea and insurance

How do you file an insurance claim in Korea?

A typical insurance claim in Korea follows these steps:

  1. Check the coverage under your policy.
  2. Notify the insurer of the accident or treatment.
  3. Submit the documents requested by the insurer.
  4. A claims handler checks the contract and policy terms and carries out any necessary investigation.
  5. Once payment and the amount have been decided, the insurer tells you the result.

Claim channels differ by insurer. They may include a mobile app, website, post, fax, a branch visit or submission through a representative. An online claim may require identity verification. A large claim, a death benefit or a claim made by an authorised representative may require original documents or an in-person submission for additional checks.

Before starting, use your policy document or account to check the coverage purchased and the insured person. For a medical-expense claim, prepare the medical bill and receipt plus any required medical documents. For a motor accident, keep the accident-report number, the other party’s details and evidence from the scene.

If you used a connected medical provider, the 실손24 service may allow medical-expense claim documents to be sent electronically to the insurer. Not every hospital, clinic or pharmacy is connected. Check the provider before relying on the service; if it is not connected, submit the documents through the insurer’s existing channels.

If the insurer asks for additional documents, confirm why they are needed and how to submit them. If a claim is paid only in part or declined, ask for the reason and the applicable policy provision in writing or another form you can retain.

An example from official insurer information

One insurer describes its process as claim submission, supporting-document submission, appointment of a handler, review and investigation, followed by the payment decision and notice of the result. It accepts claims through channels including mobile, web, post, branch visits and fax.

This is one insurer’s operating process. Submission limits, original-document requirements, identity verification and handling steps may vary by insurer and claim type.

What foreign residents should pay particular attention to

  • Confirm whether the policyholder or the insured person is entitled to file the claim.
  • If Korean mobile verification is difficult, ask in advance how to submit from abroad.
  • Before leaving Korea, obtain medical documents for treatment you have not yet claimed.
  • If you cannot understand a Korean decision notice, ask for an explanation of the reason for payment or non-payment.
  • Do not send medical certificates, passport numbers or other sensitive documents through this site’s private inquiry form.

Official sources and examples

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How do you file an insurance claim in Korea? | Elise explains insurance