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KMID : 1234820170180020075
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Korean Society of Law and Medicine
2017 Volume.18 No. 2 p.75 ~ p.103
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Civil law study on the arbitrary uninsured medical benefits
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Bae Byung-Il
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Abstract
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There are three types of benefits in the National Health Insurance Act of Korea. Those are the treatment benefit, statutory uninsured medical benefits and arbitrary uninsured medical benefits. Recently the Korea Supreme Court changed its past legal theory and permitted the arbitrary uninsured medical benefits under the strictly exceptional conditions. According to the Supreme Court’s decision, the existence of procedural difficulty, the medical necessity and the patient’s consent are necessarily required in order to allow the legal exceptions in arbitrary uninsured medical benefits. Among the three requirements, the doctor’s explanation and the patient’s fully informed consent are the most important essentials in this legal conflict. The requirement concerning the doctor’s explanation and the patient’s consent roles like a hole in the ice as a breathing hole in the arbitrary uninsured medical benefits. The most cases dismissed after Supreme Court Decision 2010DU27639, 27646 Decided June 18, 2012. were due to the defect of three requirements.
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KEYWORD
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treatment benefit, statutory uninsured medical benefits, arbitrary uninsured medical benefits, health insurance, civil law
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