Business · Companies · 17 hrs ago
South Korean insurers expand efforts to resolve benefit disputes
South Korean insurers are expanding efforts to resolve insurance claim disputes and protect consumers.
Consumer-protection cases involving insurance reached 1,158 last year, down from 1,186 in 2024 and 1,234 in 2023, but disputes continue.
They can arise when insurers and customers disagree over policy wording, whether treatment qualifies for coverage or whether a customer disclosed relevant health information.
Kyobo Life is using AI and digital systems to improve claim reviews and payments, including automated assessment and document-reading tools.
Shinhan Life has appointed three outside experts to its consumer rights committee, where they will have the same review and decision powers as internal members for two years.
The changes aim to make decisions fairer and build trust, while insurers say claims still need checks to prevent payments outside policy rules that could raise premiums for other customers.
South Korean insurers are expanding measures to address benefit disputes and strengthen consumer protection.
The Korea Consumer Agency recorded 1,158 insurance-sector consumer remedies last year, down from 1,186 in 2024 and 1,234 in 2023.
Disputes can arise over policy terms, whether a treatment qualifies for coverage, or whether a customer met disclosure duties.
Kyobo Life is improving its claims process with artificial intelligence and digital systems, while Shinhan Life appointed three external experts to its consumer-rights committee.
An industry representative said insurers are reviewing claims to ensure payments meet policy standards and to help prevent premium increases for other policyholders.
- Who
- South Korean insurers, including Kyobo Life and Shinhan Life, are expanding measures to address benefit disputes.
- What
- Insurers are improving claims systems and bringing external experts into consumer-protection reviews.
- When
- The report was published on November 8, 2026. It cited consumer remedy figures for 2023, 2024 and last year.
- Where
- South Korea.
- Why
- Disputes over coverage, policy terms and customers’ disclosure duties continue, prompting insurers to strengthen consumer protection and claims processes.
Policyholders
Insurers
Coverage for treatment
Policyholders
Policyholders may argue that treatment received on medical professionals’ advice is part of their care.
Insurers
Insurers may consider the treatment not to be direct treatment and refuse payment.
Claim decisions
Policyholders
Policyholders may seek remedies when they believe benefits were denied or underpaid.
Insurers
Insurers say claims that do not meet payment criteria must be checked to help prevent premium increases for other policyholders.
The Korea Consumer Agency recorded 1,234 insurance-sector consumer remedy cases.
The agency recorded 1,186 cases.
The agency recorded 1,158 cases.
Kyobo Life has been improving its claims process, and Shinhan Life appointed three external experts to its consumer-rights committee.
- Consumer remedies, 2023
- 1,234 cases
- Consumer remedies, 2024
- 1,186 cases
- Consumer remedies, last year
- 1,158 cases
- Kyobo Life
- Uses AI-based automated assessment and optical character recognition for claim documents.
- Shinhan Life
- Appointed 3 external experts to its Consumer Rights Protection Committee for 2 years
What people are saying
Insurers are reorganizing their systems to strengthen consumer protection and pay insurance benefits quickly.
Payments that do not meet the payment criteria are also subject to verification, if only to prevent premium increases for the many policyholders acting in good faith.