"Nylon Patients" Who Rushed to Korean Medicine Hospitals for Minor Scratches... The 8-Week Rule Has Dropped

Appropriateness Review Required for Grade 12 to 14 Patients Exceeding Eight Weeks of Treatment
Expected to Curb Insurance Leakage, but Medical Community Backlash Remains a Variable

Starting in April, the so-called "8-week rule" will be introduced, under which minor traffic-accident patients will have to undergo a separate review if they wish to receive treatment for more than eight weeks. The aim is for a public institution to determine whether long-term treatment is really necessary for patients with relatively minor injuries in grades 12 to 14, in order to curb excessive medical treatment under auto insurance and reduce leakage of insurance payouts.

Recently, the Ministry of Land, Infrastructure and Transport announced that it plans to implement the revised Enforcement Rules of the Automobile Accident Compensation Security Act from April 1. Financial authorities have also announced revisions to the relevant insurance business supervision regulations and begun preparations for the implementation of the system. However, the specific review criteria and operating methods are still being finalized in detail.

The core of the system is that if a minor-injury patient wishes to continue treatment beyond eight weeks, the patient must undergo a review by an institution designated by law to verify whether the treatment is appropriate. Statistics showing that more than 90% of minor-injury patients complete treatment within eight weeks form the basis for this system. An analysis has also been reflected that, in reality, while the average treatment period for patients who do not exceed eight weeks is about two weeks, among those who exceed eight weeks, the proportion who go on to receive long-term treatment of 21 weeks or more is high.

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The government expects this measure to help reduce so-called "nylon patients" (those who deliberately prolong treatment to receive more insurance money) and stabilize the loss ratio of auto insurance. Another background factor behind the push for the system is that large non-life insurers recorded auto insurance loss ratios in the 96% range last year, leading to accumulated deficits. In the industry, there are also projections that if insurance losses decrease, there could be room to lower premiums in the future.

The review is expected to be carried out not by insurance companies but by a public institution under the Ministry of Land, Infrastructure and Transport. This reflects concerns that fairness could be undermined if insurers were directly involved. The Korea Insurance Development Institute is also developing a system that analyzes treatment data by gender, age, and injury grade to present appropriate treatment durations, and this is expected to be used to help the system take root smoothly.

However, potential backlash from the medical community, especially Korean medicine practitioners, is likely to be a variable. They argue that there is insufficient medical evidence for the eight-week benchmark and that it could restrict patients' freedom to choose their treatment. In clinical settings, there are also criticisms that, given the inherent difficulty of objectively measuring pain, it is hard to judge the need for long-term treatment based solely on the length of the treatment period.

In response, the Ministry of Land, Infrastructure and Transport stressed that "this is not a system that bans treatment beyond eight weeks, but a procedure to verify its necessity through additional documentation," emphasizing that it does not restrict treatment itself.

This content was produced with the assistance of AI translation services.