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Court puts brakes on insurers’ reckless suits against hospitals[Top 10 Medical News in 2019] ⑧
  • By Kim Eun-young
  • Published 2019.12.30 11:35
  • Updated 2019.12.30 17:20
  • comments 0

As an online video claiming that dog dewormer fenbendazole could cure cancer went viral, cancer patients conducted “voluntary clinical trials,” trying the canine treatment on themselves in desperate hope. The medical industry had significant legal issues, including the Constitutional Court’s ruling that the 66-year-old anti-abortion law was unconstitutional. Hospitals suffered the worst shortage of physicians this year. The sudden death of Yoon Han-deok, chief of the National Emergency Medical Center, who died of a heart attack at his office, and a patient’s murder of Lim Se-won, a psychiatrist at Kanguk Samsung Hospital, have cast light on doctors’ overwork and safety issues. Amid the controversy over the appointment of Cho Kuk as the minister of justice, his daughter’s being listed as the lead author in a paper published in a medical journal during her high school time became the center of the controversy. Korea Biomedical Review has compiled the 10 biggest medical stories in 2019. —Ed.

A Seoul court stopped indemnity insurance companies from indiscriminately filing lawsuits against medical institutions regarding ultrasound-guided vacuum-assisted breast benign legion resection, also known as Mammotome procedure, and pain scrambler therapies.

The Seoul Central District Court recently dismissed a lawsuit against eight people filed by Samsung Fire and Marine Insurance, which accused them of unfairly taking indemnity insurance payment.

Earlier in July, the health authorities recognized the Mammotome procedure as new medical technology.

Since late last year, however, private insurers, including Samsung Fire and Marine Insurance and Hyundai Marine and Fire Insurance, have taken legal actions against hospitals that have provided Mammotome procedures, calling the procedures as “unfounded medical practice” and demanding a return of the indemnity insurance coverage for the medical expenses.

The total amount of the insurers’ desired return of payments reportedly amounted to 100 billion won ($86.1 million).

Separately, insurers also filed 21 complaints with the Korean Hospital Association regarding the Mammotome procedure, and they demanded a return of 3 billion won worth indemnity insurance benefits.

Insurers also targeted pain scrambler therapies. They argued that the use of pain scrambler therapy equipment to relieve pain with electrodes for a patient with an acute pain rather than chronic pain should have been non-reimbursable.

The litigations began in June with Samsung Fire and Marine Insurance’s suit against an operator of a hospital, which provided the Mammotome procedure for 96 patients (medical expenses worth 98 million won in total), and pain scrambler therapies for 53 patients (medical costs worth 57 million won). The company claimed that the patients unfairly took the indemnity insurance benefits.

Six months after the start of the trial, the court ruled that Samsung Fire and Marine’s claim was illegitimate, however.

The medical community was rattled by the moves of the private insurance firms, which called the Mammotome procedure as an unfounded medical practice because the procedure has been provided worldwide for over 20 years.

The latest ruling was the first of many lawsuits involving the Mammotome procedure, and it is expected to affect other similar lawsuits.

key@docdocdoc.co.kr

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