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KMID : 0986720110190020065
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Korean Journal of Medicine and Law
2011 Volume.19 No. 2 p.65 ~ p.80
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A Review on the Validity of the Benefit Restriction in the National Health Insurance due to the Duplicate Coverage between National Health Insurance and Automobile Insurance in Automobile Accidents
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Song Ki-Min
Shin Hyun-Ho
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Abstract
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The purpose of this study is to suggest a way to rationalize the payment system of National Health Insurance(hereinafter "NHI") by analysing the validity of the benefit restriction in the National Health Insurance Act due to the duplicate coverage between NNI and automobile insurance in automobile accidents.
Since the NHI and automobile insurance in Korea are introduced in different times and are operated separately, they have problems of duplicate benefits and omissions. There is need to be appropriately, not too much or too little, compensated with respect to the damages occurred on automobile accidents in social security. In particular, in the part of medical fee, the benefit limitation due to the combined benefits between NHI and automobile insurance shall be in the intent of the provisions. And what"s more, there has been to interpret the law arbitrarily.
From this point of view, the withholdment of benefit in NHI shall be limited to the cost of medical care because the benefit coverage of the automobile insurance and of NHI on medical care are same in auto accidents.
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KEYWORD
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Benefit Restriction, duplicate(combined) coverage, National Health Insurance, Automobile Insurance
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