(1) Reasons for Proposal

This amendment aims to improve the scope and conditions of examination by the third insurance new product consultation body and provide a preliminary review procedure to be followed when an insurance company intends to prepare and change the basic documents in accordance with attached Table 7 No. 3 of the Enforcement Decree of the Insurance Business Act as a follow-up to the improvement of the system to strengthen the pre-verification of insurance policies among plans to improve insurance policies for easier understanding by consumers which were announced in October 2019.

(2) Major Provisions

A. Improve the scope, etc., of examining the insurance new product consultation body by the insurance association (Article 7-63) 

Expand the scope of the examination by the third insurance new product consultation body of the insurance association from products for inpatient/outpatient treatment corresponding to attached Table 6 No. 1 of the Decree to products that apply new guarantees or insurance payment conditions that are not sold by the insurance company or other insurance companies. Also, clearly set insurance benefit payment restrictions as an examination condition to be medically reasonable and understandable by consumers.

B. Establish preliminary deliberation procedures by legal experts (compliance officers) and medical personnel when an insurance company intends to prepare and change basic documents in accordance with attached Table 7 No. 3 of the Decree (Article 7-72-1 newly inserted) 

Require taking a deliberation on violations, etc., of laws and regulations by law experts (compliance officers) when an insurance company intends to prepare and change basic documents in accordance with attached Table 7 No. 3 of the Decree and medical personnel’s deliberation on the adequacy of insurance benefit payment restrictions, etc., in the case of new coverage not sold by the insurance company or third insurance products that apply insurance benefit payment restrictions.