Background
Our client was a health insurance subscriber who, given the nature of their work, travelled in and out of Korea frequently. The National Health Insurance Service assessed an additional reconciliation premium of roughly KRW 19 million after examining our client's periods of overseas residence, and Changchun represented our client (the plaintiff) in challenging that assessment.
The Issue — "Overseas Residence," Suspension of Benefits, and Premium Assessment
Under the National Health Insurance Act, benefits are suspended for any period during which a subscriber resides abroad, and premium assessment changes accordingly. Benefits are suspended only where the subscriber resides abroad for "one month or more" (a stay of less than a month is not a ground for suspension), so where frequent departures and arrivals make monthly periods abroad uneven, the central question becomes whether the premium assessed for each month is appropriate.
What Changchun Argued
Changchun (attorneys Jaesun Yoon and Younghoon Jung) compiled our client's departure, arrival and treatment records month by month with precision, and examined one by one whether the premium assessed for each month was lawful in light of the period spent abroad and whether benefits were suspended or restored.
Outcome
Of the several months assessed, the court found the assessment for December 2019 (about KRW 3 million) unlawful and revoked it. The assessments for the remaining periods were upheld.
For subscribers who travel abroad frequently, both the suspension of benefits and the assessment of premiums turn on the period of overseas residence (measured against the one-month threshold). A precise, month-by-month examination of immigration records can isolate the portions assessed improperly. (Outcomes may differ depending on the facts of each matter.)