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Insurance Claim Assistant

Check the required documents for each claim type, and copy English templates for guidance.

What are Insurance Claim Documents?
In South Korea, insurance claims (medical reimbursement) require specific certificates from the hospital. Common documents include Medical Receipts, Detailed Statements, and Diagnosis Certificates. Most claims under 1M KRW can be filed via mobile apps using photo uploads.

Select Claim Type

Expert Tips
  • For Silson claims over 100k KRW, a Detailed Statement (세부내역서) is mandatory.
  • Verify that every document has the Hospital Official Seal.
  • Ask if a Medical Result Form can replace a Diagnosis paper to save ~20k KRW in fees.
Standard

Outpatient Claim Checklist

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How to Claim Medical Insurance in Korea

Step-by-Step Filing Guide

Filing an insurance claim in South Korea is highly digitized. Most major insurers like **Samsung Fire**, **Hyundai Marine**, and **Meritz** allow you to file claims directly through their mobile apps. For claims under 1 million KRW, you typically only need to upload clear photos of your documents.

  1. 01. Request Papers

    Ask for "Silson insurance documents" at the hospital desk when paying.

  2. 02. Photo Upload

    Use the insurer's app to take high-resolution photos of each document.

  3. 03. Review & Payout

    Review usually takes 1-3 business days. Funds are wired to your ARC-linked bank account.

Key Korean Terms for Hospital Staff

When talking to the hospital administration, using these terms will ensure you get the correct paperwork:

"Yeong-su-jeung" 영수증 / Medical Receipt
"Se-bu-nae-yeok-seo" 세부내역서 / Detailed Statement
"Jin-dan-seo" 진단서 / Diagnosis Certificate

How to Maximize Your Payout

  • Consolidate Small Claims: Don't file every 10,000 KRW visit individually. Collect receipts for 3-6 months and file them in one batch to save time.
  • Check Your Special Riders: Many expats only claim for the "Silson" (reimbursement) part but forget about **Daily Hospitalization Indemnity** or **Surgery Riders**.
  • Emergency Room Tips: If you visited the ER for a non-emergency reason, Silson may not cover the full "ER Fee" (usually around 60k KRW). Check if your policy has an ER-specific rider.

Assistant FAQ

What is the "Deductible" (Gong-je-geum)?
Every Silson claim has a deductible. For general clinics, it's usually **10,000 KRW**; for general hospitals, it's **15,000 KRW**; and for large university hospitals, it's **20,000 KRW**. Your payout will be the total cost minus this deductible.
Do I need to translate my documents?
If you are claiming from a **Korean insurer**, you do NOT need to translate them; they use the Korean papers directly. If you are claiming from a **foreign/travel insurer**, you should request an English version from the hospital or use a professional translation service.

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