ENGLISH

- A person who disputes a disposition of eligibility, premiums, or benefits of an employer-sponsored insurance subscriber or his/her dependent by the Service can raise a dispute with the Service (Paragraph 1 of Article 87 of the National Health Insurance Act).

- A dispute must be raised in writing (electronic documents included) within 90 days after the day on which the person raising a dispute becomes aware of the disposition to be disputed; after 180 days, disputes cannot be raised. However, a dispute may be raised even after the deadline if it can be proved that the dispute could not have been raised by the deadline (Paragraph 3 of Article 87 of the National Health Insurance Act).

- A person seeking to raise a dispute must complete and submit a dispute claim form (Attached Template No. 32 of the Enforcement Regulations of the National Health Insurance Act) to the National Health Insurance Service (head office or a branch office) in person or by mail or fax.

- Instead of downloading a template, log in with a financial authentication certificate and make a dispute claim on the website of the National Health Insurance Service (National Health Insurance Service website Overview Dispute Claims Committee Dispute Claim Method/Template).

- The Service and the Health Insurance Review and Assessment Service must issue a decision on a raised dispute within 60 days (the main sentence of Paragraph 1 of Article 58 of the Enforcement Decree of the National Health Insurance Act).

- If a compelling reason exists, the deliberation period can be extended by up to 30 days. If the deliberation period is to be extended, the person who raised the dispute must be notified of the extension by 7 days before the end of the deliberation period (the proviso of Paragraph 1 and Paragraph 2 of Article 58 of the Enforcement Decree of the National Health Insurance Act).

- Upon reaching a decision regarding a dispute that has been raised, the Service and the Health Insurance Review and Assessment Service must without delay send the original written decision to the claimant and a copy to any interested parties (Article 57 of the Enforcement Decree of the National Health Insurance Act).

- A person who disagrees with a decision regarding a dispute can request a review by the Health Insurance Disputes Resolution Committee (the former part of Paragraph 1 of Article 88 of the National Health Insurance Act).

- A request for review must be made in writing (electronic documents included) within 90 days after the day on which the person raising a dispute becomes aware of the decision by the Service on a dispute raised; after 180 days, a request for review cannot be made. However, a request may be made even after the deadline if it can be proven that the request could not have been made by the deadline (Paragraph 3 of Article 87 and the latter part of Paragraph 1 of Article 88 of the National Health Insurance Act).

- A person seeking to request a review can submit a review request form to the Service, the Health Insurance Review and Assessment Service, or the Health Insurance Disputes Resolution Committee in person or by mail or fax (Article 59 of the Enforcement Decree of the National Health Insurance Act and National Health Insurance Service website Overview Dispute Claims Committee FAQ).

- Make a request for review online at the website of the Health Insurance Disputes Resolution Committee (hisimpan.mohw.go.kr) or the Health Insurance Review and Assessment Service (www.hira.or.kr).

- The Health Insurance Disputes Resolution Committee must issue a decision on a requested review within 60 days (the main sentence of Paragraph 1 of Article 61 of the Enforcement Decree of the National Health Insurance Act).

- If a compelling reason exists, the deliberation period can be extended by up to 30 days. If the deliberation period is to be extended, the person who requested the review must be notified of the extension by 7 days before the end of the deliberation period (the proviso of Paragraph 1 and Paragraph 2 of Article 61 of the Enforcement Decree of the National Health Insurance Act).

- Upon reaching a decision on a requested review, the chairman of the Health Insurance Disputes Resolution Committee shall sign or seal the written decision, and send the original to the claimant and a copy to any interested parties, including persons who were issued a disposition (Article 60 of the Enforcement Decree of the National Health Insurance Act).