ENGLISH

- Any person not satisfied with the decision of the NHIS on the eligibility, insurance premiums, insurance benefits, and insurance benefit costs for the self-employed insured may raise a formal objection to the NHIS (Article 87 (1) of the National Health Insurance Act).

- Any formal objection must be filed in writing within 90 days after the date the person became aware of such decision and he/she will be barred from filing the objection after 180 days from the date on which the decision was made. However, objection may be made if an explanation is provided stating the reason why the objection within the relevant period could not be raised due to a reasonable ground (Article 87 (3) of the “National Health Insurance Act”).

- A person who wishes to file an objection must fill out an application for objection (attached Form No. 32 in the “Enforcement Rule of the National Health Insurance Act”) and submit it to the National Health Insurance Service (branches nationwide, regional headquarters, or head office) by personal visit or by mail or fax to file an objection.

- The NHIS and the Health Insurance Review and Assessment Service must make their decision within 60 days from the date on which the objection was filed (main text of Article 58 (1) of the “Enforcement Decree of the National Health Insurance Act”).

- However, under a compelling cause, the period may be extended by up to 30 days, and at this time, in order to extend the period required for the decision, the person who filed the objection must be notified of the fact at least 7 days prior to the end of the period initially required to render a decision (proviso to Article 58 (1) and (2) of the “Enforcement Decree of the National Health Insurance Act”).

- Once the decision is made on the objection raised, the NHIS and the Health Insurance Review and Assessment Service must send the original copy of the decision to the applicant without delay and send a duplicate thereof to the parties concerned (Article 57 of the “Enforcement Decree of the National Health Insurance Act”).

- A person who demurs to a decision on the objection filed may request the Health Insurance Dispute Mediation Committee for a trial (former part of Article 88 (1) of the “National Health Insurance Act”).

- The request for judgment must be filed in writing within 90 days after the date the person became aware of the decision made by the NHIS on the objection filed and he/she will be barred from filing the objection after 180 days from the date on which the decision on the objection was made. However, a trial request may be made if an explanation is provided stating the reason why the request for judgment within the relevant period could not be filed due to a reasonable ground (latter part of Article 88 (1) and Article 87 (3) of the “National Health Insurance Act”).

- A person who wishes to file the request for judgment must file the application to the Health Insurance Review and Assessment Service or the Health Insurance Dispute Mediation Committee in person or by mail (Article 59 of the “Enforcement Decree of the National Health Insurance Act”).

- The Health Insurance Dispute Mediation Committee must make a decision within 60 days from the date on which the request for judgment was filed (main text of Article 61 (1) of the “Enforcement Decree of the National Health Insurance Act”).

- However, under a compelling cause, the period may be extended by up to 30 days, and at this time, in order to extend the period required for decision, the applicant must be notified of the fact at least 7 days prior to the end of the period initially required to render a decision (proviso to Article 61 (1) and (2) of the “Enforcement Decree of the National Health Insurance Act”).

- Once the Chairperson of the Health Insurance Dispute Mediation Committee makes a decision on the request for judgment, the Chairperson must affix his/her signature and seal to the written decision stating the gist of the request for judgment among others, and send the original copy of the decision to the applicant without delay, and a duplicate copy to a person has taken the disposition as well as to the parties concerned (Article 60 of the “Enforcement Decree of the National Health Insurance Act”).