Korea: Expanded Consumer Choice in Medical Consultations - FSS & KMA Agreement

A new agreement between South Korea’s Financial Supervisory Service (FSS) and the Korean Medical Association (KMA) aims to increase consumer choice and objectivity in medical consultations related to insurance claims. The agreement, formalized on February 4, 2026, establishes a framework for insurance consumers to select the KMA as their third-party medical advisory body.

Expanding Consumer Rights in Insurance Disputes

Currently, when insurance disputes require a third-party medical review, consumers have been limited to choosing from hospitals designated by the insurance company. This arrangement has raised concerns about potential bias, as the entity paying for the review also selects the reviewer. The new agreement addresses this concern by allowing consumers to opt for medical advice from the KMA, which will independently select qualified consultants.

Expert Insight:

Expert Insight: This collaboration represents a significant shift towards patient-centered healthcare dispute resolution. By empowering consumers with a choice of medical advisory body, the agreement seeks to bolster trust in the insurance claims process and ensure fairer outcomes.

The KMA’s medical advisory panel will consist of specialists from general and tertiary hospitals. Initially, the programme will focus on three areas of insurance: cerebrovascular, cardiovascular, and orthopedic injuries, with plans for gradual expansion.

Collaboration and Implementation

The agreement was signed by FSS Director-General Lee Chan-jin and KMA President Kim Taek-woo, with participation from key officials from both organizations, including FSS Deputy Director-General Seo Young-il and KMA Secretary-General Kim Seung-soo. Lee Chan-jin stated that the agreement marks a “crucial turning point” in transitioning medical consultations from being insurance-company-centric to consumer-centric. Kim Taek-woo expressed his organization’s commitment to providing objective medical advice and strengthening patient rights.

Did You Know? The agreement was signed on February 4, 2026, with detailed implementation plans scheduled for the second and third quarters of 2026.

Detailed implementation plans are expected to be finalized in the first quarter of 2026. A pilot programme focusing on cerebrovascular, cardiovascular, and orthopedic disability assessments is planned for the second and third quarters of 2026. Following a review of the pilot programme’s effectiveness, the scope of medical consultations covered by the agreement may be expanded.

Frequently Asked Questions

What is the purpose of this agreement?

The agreement aims to increase objectivity and consumer choice in third-party medical consultations related to insurance claims.

Who is involved in this agreement?

The agreement is between the Financial Supervisory Service (FSS) and the Korean Medical Association (KMA).

When will this agreement be implemented?

Detailed plans will be finalized in the first quarter of 2026, with a pilot programme planned for the second and third quarters of 2026.

As the implementation of this agreement progresses, will it lead to a more transparent and equitable process for resolving insurance-related medical disputes?

Korea: Expanded Consumer Choice in Medical Consultations – FSS & KMA Agreement