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KMID : 0365220130500010001
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Korean Journal of Public Health
2013 Volume.50 No. 1 p.1 ~ p.14
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Problems and Overhaul of Remedy for Violation of Private Right under Health Insurance Law
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Jung Min-Soo
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Abstract
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Remedy for violation of private right under the social security system manifests definite principles to guarantee the viable right to survival for the insured who stand on the footing of the socially weak. However, there are growing demands for remedy for violation of private right under health insurance amid a more complex medical environment and higher awareness of rights among those concerned with health insurance, thereby fueling a rapid rise in objections and claims for administrative adjudication. With such surge in objections and claims for administrative adjudication, the authorities has difficulty in handling them within the statutory period, and normal operation remains hard for remedy for violation of private right under health insurance. It raises the necessity for improved administrative system plus greater efficiency in operational system with regard to remedy for violation of private right under health insurance. This study examined current status of other Korean remedies for violation of private right and advanced nations" remedies for violation of private right under health insurance, identify specific problems in objections and claimed for adjudication as part of remedy for violation of private right pursuant to the National Health Insurance Act of Korea, and suggested viable solutions thereto. According to the review, it was crucial to attain external rationalization through prevention of unnecessary objections and efficient handling of objections handling while internally solidifying a consumer-centered remedy for violation of private right. In the medium and long term, it was also necessary to expand the Health Insurance Review & Assessment Service and reorganize the Health Insurance Dispute Mediation Committee for better handling of constantly growing examination cases. The findings of this study suggest that we need to ensure expertise, impartiality, and rapidity for overall screening and handling of examination cases.
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KEYWORD
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Health Insurance, Remedy for Violation of Private Right, Social Security, Law, South Korea
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