{"content_id":"gd9koekjbr","slug":"health-checkup-insurance-coverage-and-claim-documents","locale":"en","schema_type":"Article","category":"knowledge_base","category_name":"Knowledge Base","title":"Health Checkup Insurance Claims: Tests and Polyp Removal","summary":"As a rule, preventive health checkup costs are excluded from indemnity health insurance coverage. Costs for additional tests prompted by abnormal findings and polyp removal can be claimed depending on your policy terms.","sponsorship_disclosure":null,"affiliate_disclosure":null,"commerce_disclosure":null,"author":{"name":"Injoys Editorial Team","url":"https://injoys.com/ko/about"},"key_points":["Finding a disease during a health checkup does not make the entire cost of the basic checkup eligible for indemnity health insurance coverage.","Claims for additional test costs are assessed based on abnormal findings and the medical necessity of the tests.","For polyp removal, check the coverage conditions for indemnity health insurance and surgery expense riders separately.","When preparing claim documents, focus on medical expense receipts and itemized statements.","The limitation period for insurance claims is 3 years under Article 662 of the Commercial Act."],"content_markdown":"Preventive health checkup costs are generally excluded from indemnity health insurance coverage. However, you may claim costs for additional tests and treatment prompted by abnormal findings. Check basic checkup costs and treatment costs separately.\n\nCoverage conditions follow your policy terms, and the claim limitation period follows the Commercial Act effective September 10, 2026.\n\n## When health checkup expenses can be claimed under indemnity insurance\n\nMedical expenses incurred after a checkup are assessed based on the purpose of the tests. Medical expense insurance is an everyday term for indemnity health insurance. It reimburses the amount you actually paid for medical expenses covered by your policy.\n\nNational health checkups and comprehensive company health checkups are primarily preventive. Comprehensive checkups chosen by individuals are classified using the same criteria. Additional medical expenses prompted by abnormal findings are reviewed separately.\n\nKB Kookmin Bank’s explanation also distinguishes checkup costs from additional medical expenses. Check your own policy terms for the actual payment conditions. [KB Kookmin Bank guide to health checkup expense claims](https://kbthink.com/insurance/claims/medical-checkup.html)\n\n## Tests and treatment by circumstance\n\nEven the same test may be assessed differently depending on whether it was part of a preventive checkup or additional medical care.\n\n| Test or treatment received | Nature of the expense | What to check |\n| --- | --- | --- |\n| Basic tests in national or company health checkups | Preventive | Basic checkup costs are generally excluded from coverage |\n| Ultrasound or MRI added as an optional checkup item | Elective screening | Paying separately does not by itself make the expense covered |\n| Additional tests performed by a doctor after abnormal findings | Medical care to diagnose disease | Medical necessity and your policy’s coverage |\n| Removal of a polyp found during endoscopy | Disease treatment | Distinction between removal costs and related test costs |\n| Biopsy performed because of abnormal findings | Additional diagnostic test | Reason for the procedure and the actual items claimed |\n| Repeat test after a recommendation for follow-up | Medical purpose needs confirmation | The doctor’s decision to order the test and medical records |\n\n### Can sedated endoscopy costs also be claimed?\n\nCoverage for sedated endoscopy is not determined solely by whether sedation was used. Costs chosen to make a preventive checkup more comfortable are unlikely to be covered. For sedation or anesthesia costs needed for treatment, check the medical care provided and your policy terms.\n\nEven if a polyp was removed, full payment of sedation costs is not guaranteed. Check how the hospital billed the checkup items and treatment items. Whether painless endoscopy can be claimed is not determined by its name alone either.\n\n### What criteria apply to ultrasound and MRI?\n\nFor ultrasound and MRI, first check the purpose of the test. Additional tests to investigate abnormalities found during a checkup may be considered for coverage. The decision is not based solely on whether the test took place at a health screening center.\n\nCovered services are medical services covered by National Health Insurance. Non-covered services are those not covered by National Health Insurance. For non-covered tests, also check the coverage of your riders.\n\nThe same MRI limits and deductibles cannot be applied to every policyholder. Check the MRI coverage provisions that apply to your policy. It is difficult to determine the expected payout before checking when you enrolled and which riders you have.\n\n### Is a recommendation for follow-up enough to ensure coverage?\n\nThe wording “follow-up” alone does not determine coverage for later test costs. You need to check why the doctor ordered another test. The assessment depends on whether testing was needed to establish a disease diagnosis during subsequent care.\n\n## Comparing indemnity insurance and surgery riders for polyp removal\n\nIf you had a polyp removed, check your indemnity insurance and surgery rider separately. Indemnity insurance is based on actual covered medical expenses. Fixed-benefit surgery coverage pays the agreed amount when the policy’s payment conditions are met.\n\n| Category | Indemnity insurance | Fixed-benefit surgery rider |\n| --- | --- | --- |\n| Payment basis | Actual covered medical expenses you paid | A surgical procedure specified in the policy |\n| Amount calculation | Accounts for out-of-pocket share and coverage limits | Accounts for the insured amount, surgery classification, and other factors |\n| Documents to check | Medical expense receipts, itemized statements, etc. | Documents confirming the procedure name, surgery date, diagnosis, etc. |\n| Claiming both | Reviewed separately from the surgery rider | Reviewed separately from indemnity insurance |\n\nPolyp removal must be distinguished from tissue sampling for diagnosis. Even if biopsy costs qualify for indemnity coverage, surgery benefit payment conditions are separate. LINA Life’s policy terms include a provision excluding diagnostic biopsies from the definition of surgery. [LINA Life Worry-Free Health Checkup Mini Insurance policy terms](https://www.lina.co.kr/cms/upload/upload/docs/disclosure/B00351002_0_P.pdf)\n\nEMR means endoscopic mucosal resection. ESD means endoscopic submucosal dissection. The procedure abbreviation alone cannot establish the surgery benefit amount.\n\nCompare the name of the procedure you actually received with your policy’s definition of surgery. Some policies use a surgery classification table or medical billing codes as payment criteria. You also need to check limits on the number of benefit payments separately.\n\n## How do diagnosis codes and medical billing codes differ?\n\nDiagnosis codes identify diseases, while medical billing codes identify the medical procedures performed. A polyp diagnosis alone does not provide all the information about which removal procedure you received. For surgery benefit claims, check what information your policy requires.\n\n| Information | What it explains | Documents to check |\n| --- | --- | --- |\n| Diagnosis and disease classification code | The disease for which you received care | Medical certificate, prescription, confirmation of medical care, etc. |\n| Procedure name and surgery date | What surgery you received and when | Surgery confirmation, medical certificate, etc. |\n| Medical billing code | Which medical procedure was billed | Itemized medical expense statement, etc. |\n\nThe LINA Life product mentioned above uses medical billing codes for some coverage. Hyundai Marine \u0026 Fire Insurance’s claims guide requires confirmation of details such as the procedure name and surgery date. First ask which information your own policy requires.\n\n## Documents for health checkup expense claims\n\nPrepare the necessary documents, starting with medical expense receipts and itemized statements. Not every claim requires a medical certificate. Additional documents vary depending on the claim and the insurer’s requirements.\n\n\u003e Please check with the insurance company which documents to submit before filing a claim.\n\u003e\n\u003e LINA Life “Non-Participating Worry-Free Health Checkup Mini Insurance” policy terms\n\n| Document | What it confirms | Preparation guidelines |\n| --- | --- | --- |\n| Medical bill and receipt | Medical expenses actually paid | Basic proof of expenses |\n| Itemized medical expense statement | Costs for each test and procedure | Used to distinguish checkup costs from treatment costs |\n| Prescription, confirmation of medical care, or medical certificate | Diagnosis and care received | Check which documents the insurer accepts |\n| Test results and medical records | Abnormal findings and reasons for additional tests | Submit if required |\n| Surgery confirmation and similar documents | Diagnosis, procedure name, and surgery date | Check when claiming surgery benefits |\n| Medication expense receipt | Prescription medication costs | Check when including medication costs in the claim |\n\nDo not treat a card transaction slip as a substitute for a medical expense receipt. Hyundai Marine \u0026 Fire Insurance’s guide states that card transaction slips are not accepted. It also excludes medical expense payment certificates issued for income tax deductions. [Hyundai Marine \u0026 Fire Insurance guide to insurance claim documents](https://www.hi.co.kr/FileActionServlet/preview/1/data/202409/be11216a9ad3015a1614c313610d5200.pdf/%EB%B3%B4%ED%97%98%EA%B8%88%EC%B2%AD%EA%B5%AC%EC%84%9C%28%EA%B8%B0%EB%B3%B8%29_%EC%88%98%EC%A0%95%EB%B3%B8.pdf)\n\n## How to file a claim and check payment details\n\nCheck your policy, then separate out the additional medical expenses when filing your claim.\n\n1. Check your insurance policy for your indemnity insurance and surgery rider coverage.\n2. Identify checkup items and additional medical care items in the itemized medical expense statement.\n3. Ask your insurer which supporting documents are needed and how to file.\n4. Submit through the channel provided, such as the insurer’s app or website.\n5. Check the payment details for excluded items and how your out-of-pocket share was applied.\n\nIf the payout is lower than expected, first request the calculation details. Even covered expenses may be reduced by deductions specified in the policy. Having multiple indemnity insurance policies does not allow you to receive more than your actual loss. [Samsung Fire \u0026 Marine Insurance explanation of indemnity reimbursement](https://product.samsungfire.com/v2/html/customer/07/F_070_010_019.html?show-element=mmList)\n\nIf payment is denied, check the applicable policy provisions and the specific reasons. If additional documents are needed, confirm what was requested and provide them. Samsung Fire \u0026 Marine Insurance’s payment procedure guide includes a process for reviewing the calculation details. [Samsung Fire \u0026 Marine Insurance guide to insurance payment procedures](https://m.samsungfire.com/download/claim/insurance_bill%28group2%29.pdf)\n\n## Common mistakes in health checkup expense claims\n\nAvoid treating the total checkup cost and additional treatment costs as the same category.\n\n- Do not assume that all costs, including the basic checkup fee, are covered after polyp removal.\n- Do not judge coverage solely by the test name, such as ultrasound or MRI.\n- Do not assume that having a biopsy also entitles you to a surgery benefit.\n- Check which alternative documents are accepted before obtaining a medical certificate.\n- Do not calculate your expected payout by multiplying the surgery benefit by the number of polyps.\n\n## What is the deadline for filing an insurance claim?\n\nUnder Article 662 of the Commercial Act, the limitation period for an insurance claim is **3 years**. This is also confirmed in the Commercial Act effective September 10, 2026. If you do not exercise your right to claim, it expires when the limitation period ends. [National Law Information Center: Commercial Act, Article 662](https://www.law.go.kr/lsLinkCommonInfo.do?lsJoLnkSeq=1017094811)\n\nThe date the limitation period starts must be checked for each individual claim. For older medical expenses, ask your insurer about the treatment date and the period in which you can file a claim. If the deadline is unclear or disputed, consider seeking legal advice.","content_html":"\u003cp\u003ePreventive health checkup costs are generally excluded from indemnity health insurance coverage. However, you may claim costs for additional tests and treatment prompted by abnormal findings. Check basic checkup costs and treatment costs separately.\u003c/p\u003e\n\u003cp\u003eCoverage conditions follow your policy terms, and the claim limitation period follows the Commercial Act effective September 10, 2026.\u003c/p\u003e\n\u003ch2\u003e\n\u003ca href=\"#when-health-checkup-expenses-can-be-claimed-under-indemnity-insurance\" class=\"anchor\" id=\"when-health-checkup-expenses-can-be-claimed-under-indemnity-insurance\"\u003e\u003c/a\u003eWhen health checkup expenses can be claimed under indemnity insurance\u003c/h2\u003e\n\u003cp\u003eMedical expenses incurred after a checkup are assessed based on the purpose of the tests. Medical expense insurance is an everyday term for indemnity health insurance. It reimburses the amount you actually paid for medical expenses covered by your policy.\u003c/p\u003e\n\u003cp\u003eNational health checkups and comprehensive company health checkups are primarily preventive. Comprehensive checkups chosen by individuals are classified using the same criteria. Additional medical expenses prompted by abnormal findings are reviewed separately.\u003c/p\u003e\n\u003cp\u003eKB Kookmin Bank’s explanation also distinguishes checkup costs from additional medical expenses. Check your own policy terms for the actual payment conditions. \u003ca href=\"https://kbthink.com/insurance/claims/medical-checkup.html\"\u003eKB Kookmin Bank guide to health checkup expense claims\u003c/a\u003e\u003c/p\u003e\n\u003ch2\u003e\n\u003ca href=\"#tests-and-treatment-by-circumstance\" class=\"anchor\" id=\"tests-and-treatment-by-circumstance\"\u003e\u003c/a\u003eTests and treatment by circumstance\u003c/h2\u003e\n\u003cp\u003eEven the same test may be assessed differently depending on whether it was part of a preventive checkup or additional medical care.\u003c/p\u003e\n\u003cdiv class=\"overflow-x-auto\"\u003e\u003ctable\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth\u003eTest or treatment received\u003c/th\u003e\n\u003cth\u003eNature of the expense\u003c/th\u003e\n\u003cth\u003eWhat to check\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd data-label=\"Test or treatment received\"\u003eBasic tests in national or company health checkups\u003c/td\u003e\n\u003ctd data-label=\"Nature of the expense\"\u003ePreventive\u003c/td\u003e\n\u003ctd data-label=\"What to check\"\u003eBasic checkup costs are generally excluded from coverage\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd data-label=\"Test or treatment received\"\u003eUltrasound or MRI added as an optional checkup item\u003c/td\u003e\n\u003ctd data-label=\"Nature of the expense\"\u003eElective screening\u003c/td\u003e\n\u003ctd data-label=\"What to check\"\u003ePaying separately does not by itself make the expense covered\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd data-label=\"Test or treatment received\"\u003eAdditional tests performed by a doctor after abnormal findings\u003c/td\u003e\n\u003ctd data-label=\"Nature of the expense\"\u003eMedical care to diagnose disease\u003c/td\u003e\n\u003ctd data-label=\"What to check\"\u003eMedical necessity and your policy’s coverage\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd data-label=\"Test or treatment received\"\u003eRemoval of a polyp found during endoscopy\u003c/td\u003e\n\u003ctd data-label=\"Nature of the expense\"\u003eDisease treatment\u003c/td\u003e\n\u003ctd data-label=\"What to check\"\u003eDistinction between removal costs and related test costs\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd data-label=\"Test or treatment received\"\u003eBiopsy performed because of abnormal findings\u003c/td\u003e\n\u003ctd data-label=\"Nature of the expense\"\u003eAdditional diagnostic test\u003c/td\u003e\n\u003ctd data-label=\"What to check\"\u003eReason for the procedure and the actual items claimed\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd data-label=\"Test or treatment received\"\u003eRepeat test after a recommendation for follow-up\u003c/td\u003e\n\u003ctd data-label=\"Nature of the expense\"\u003eMedical purpose needs confirmation\u003c/td\u003e\n\u003ctd data-label=\"What to check\"\u003eThe doctor’s decision to order the test and medical records\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\u003c/div\u003e\n\u003ch3\u003e\n\u003ca href=\"#can-sedated-endoscopy-costs-also-be-claimed\" class=\"anchor\" id=\"can-sedated-endoscopy-costs-also-be-claimed\"\u003e\u003c/a\u003eCan sedated endoscopy costs also be claimed?\u003c/h3\u003e\n\u003cp\u003eCoverage for sedated endoscopy is not determined solely by whether sedation was used. Costs chosen to make a preventive checkup more comfortable are unlikely to be covered. For sedation or anesthesia costs needed for treatment, check the medical care provided and your policy terms.\u003c/p\u003e\n\u003cp\u003eEven if a polyp was removed, full payment of sedation costs is not guaranteed. Check how the hospital billed the checkup items and treatment items. Whether painless endoscopy can be claimed is not determined by its name alone either.\u003c/p\u003e\n\u003ch3\u003e\n\u003ca href=\"#what-criteria-apply-to-ultrasound-and-mri\" class=\"anchor\" id=\"what-criteria-apply-to-ultrasound-and-mri\"\u003e\u003c/a\u003eWhat criteria apply to ultrasound and MRI?\u003c/h3\u003e\n\u003cp\u003eFor ultrasound and MRI, first check the purpose of the test. Additional tests to investigate abnormalities found during a checkup may be considered for coverage. The decision is not based solely on whether the test took place at a health screening center.\u003c/p\u003e\n\u003cp\u003eCovered services are medical services covered by National Health Insurance. Non-covered services are those not covered by National Health Insurance. For non-covered tests, also check the coverage of your riders.\u003c/p\u003e\n\u003cp\u003eThe same MRI limits and deductibles cannot be applied to every policyholder. Check the MRI coverage provisions that apply to your policy. It is difficult to determine the expected payout before checking when you enrolled and which riders you have.\u003c/p\u003e\n\u003ch3\u003e\n\u003ca href=\"#is-a-recommendation-for-follow-up-enough-to-ensure-coverage\" class=\"anchor\" id=\"is-a-recommendation-for-follow-up-enough-to-ensure-coverage\"\u003e\u003c/a\u003eIs a recommendation for follow-up enough to ensure coverage?\u003c/h3\u003e\n\u003cp\u003eThe wording “follow-up” alone does not determine coverage for later test costs. You need to check why the doctor ordered another test. The assessment depends on whether testing was needed to establish a disease diagnosis during subsequent care.\u003c/p\u003e\n\u003ch2\u003e\n\u003ca href=\"#comparing-indemnity-insurance-and-surgery-riders-for-polyp-removal\" class=\"anchor\" id=\"comparing-indemnity-insurance-and-surgery-riders-for-polyp-removal\"\u003e\u003c/a\u003eComparing indemnity insurance and surgery riders for polyp removal\u003c/h2\u003e\n\u003cp\u003eIf you had a polyp removed, check your indemnity insurance and surgery rider separately. Indemnity insurance is based on actual covered medical expenses. Fixed-benefit surgery coverage pays the agreed amount when the policy’s payment conditions are met.\u003c/p\u003e\n\u003cdiv class=\"overflow-x-auto\"\u003e\u003ctable\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth\u003eCategory\u003c/th\u003e\n\u003cth\u003eIndemnity insurance\u003c/th\u003e\n\u003cth\u003eFixed-benefit surgery rider\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd data-label=\"Category\"\u003ePayment basis\u003c/td\u003e\n\u003ctd data-label=\"Indemnity insurance\"\u003eActual covered medical expenses you paid\u003c/td\u003e\n\u003ctd data-label=\"Fixed-benefit surgery rider\"\u003eA surgical procedure specified in the policy\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd data-label=\"Category\"\u003eAmount calculation\u003c/td\u003e\n\u003ctd data-label=\"Indemnity insurance\"\u003eAccounts for out-of-pocket share and coverage limits\u003c/td\u003e\n\u003ctd data-label=\"Fixed-benefit surgery rider\"\u003eAccounts for the insured amount, surgery classification, and other factors\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd data-label=\"Category\"\u003eDocuments to check\u003c/td\u003e\n\u003ctd data-label=\"Indemnity insurance\"\u003eMedical expense receipts, itemized statements, etc.\u003c/td\u003e\n\u003ctd data-label=\"Fixed-benefit surgery rider\"\u003eDocuments confirming the procedure name, surgery date, diagnosis, etc.\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd data-label=\"Category\"\u003eClaiming both\u003c/td\u003e\n\u003ctd data-label=\"Indemnity insurance\"\u003eReviewed separately from the surgery rider\u003c/td\u003e\n\u003ctd data-label=\"Fixed-benefit surgery rider\"\u003eReviewed separately from indemnity insurance\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\u003c/div\u003e\n\u003cp\u003ePolyp removal must be distinguished from tissue sampling for diagnosis. Even if biopsy costs qualify for indemnity coverage, surgery benefit payment conditions are separate. LINA Life’s policy terms include a provision excluding diagnostic biopsies from the definition of surgery. \u003ca href=\"https://www.lina.co.kr/cms/upload/upload/docs/disclosure/B00351002_0_P.pdf\"\u003eLINA Life Worry-Free Health Checkup Mini Insurance policy terms\u003c/a\u003e\u003c/p\u003e\n\u003cp\u003eEMR means endoscopic mucosal resection. ESD means endoscopic submucosal dissection. The procedure abbreviation alone cannot establish the surgery benefit amount.\u003c/p\u003e\n\u003cp\u003eCompare the name of the procedure you actually received with your policy’s definition of surgery. Some policies use a surgery classification table or medical billing codes as payment criteria. You also need to check limits on the number of benefit payments separately.\u003c/p\u003e\n\u003ch2\u003e\n\u003ca href=\"#how-do-diagnosis-codes-and-medical-billing-codes-differ\" class=\"anchor\" id=\"how-do-diagnosis-codes-and-medical-billing-codes-differ\"\u003e\u003c/a\u003eHow do diagnosis codes and medical billing codes differ?\u003c/h2\u003e\n\u003cp\u003eDiagnosis codes identify diseases, while medical billing codes identify the medical procedures performed. A polyp diagnosis alone does not provide all the information about which removal procedure you received. For surgery benefit claims, check what information your policy requires.\u003c/p\u003e\n\u003cdiv class=\"overflow-x-auto\"\u003e\u003ctable\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth\u003eInformation\u003c/th\u003e\n\u003cth\u003eWhat it explains\u003c/th\u003e\n\u003cth\u003eDocuments to check\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd data-label=\"Information\"\u003eDiagnosis and disease classification code\u003c/td\u003e\n\u003ctd data-label=\"What it explains\"\u003eThe disease for which you received care\u003c/td\u003e\n\u003ctd data-label=\"Documents to check\"\u003eMedical certificate, prescription, confirmation of medical care, etc.\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd data-label=\"Information\"\u003eProcedure name and surgery date\u003c/td\u003e\n\u003ctd data-label=\"What it explains\"\u003eWhat surgery you received and when\u003c/td\u003e\n\u003ctd data-label=\"Documents to check\"\u003eSurgery confirmation, medical certificate, etc.\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd data-label=\"Information\"\u003eMedical billing code\u003c/td\u003e\n\u003ctd data-label=\"What it explains\"\u003eWhich medical procedure was billed\u003c/td\u003e\n\u003ctd data-label=\"Documents to check\"\u003eItemized medical expense statement, etc.\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\u003c/div\u003e\n\u003cp\u003eThe LINA Life product mentioned above uses medical billing codes for some coverage. Hyundai Marine \u0026amp; Fire Insurance’s claims guide requires confirmation of details such as the procedure name and surgery date. First ask which information your own policy requires.\u003c/p\u003e\n\u003ch2\u003e\n\u003ca href=\"#documents-for-health-checkup-expense-claims\" class=\"anchor\" id=\"documents-for-health-checkup-expense-claims\"\u003e\u003c/a\u003eDocuments for health checkup expense claims\u003c/h2\u003e\n\u003cp\u003ePrepare the necessary documents, starting with medical expense receipts and itemized statements. Not every claim requires a medical certificate. Additional documents vary depending on the claim and the insurer’s requirements.\u003c/p\u003e\n\u003cblockquote\u003e\n\u003cp\u003ePlease check with the insurance company which documents to submit before filing a claim.\u003c/p\u003e\n\u003cp\u003eLINA Life “Non-Participating Worry-Free Health Checkup Mini Insurance” policy terms\u003c/p\u003e\n\u003c/blockquote\u003e\n\u003cdiv class=\"overflow-x-auto\"\u003e\u003ctable\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth\u003eDocument\u003c/th\u003e\n\u003cth\u003eWhat it confirms\u003c/th\u003e\n\u003cth\u003ePreparation guidelines\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd data-label=\"Document\"\u003eMedical bill and receipt\u003c/td\u003e\n\u003ctd data-label=\"What it confirms\"\u003eMedical expenses actually paid\u003c/td\u003e\n\u003ctd data-label=\"Preparation guidelines\"\u003eBasic proof of expenses\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd data-label=\"Document\"\u003eItemized medical expense statement\u003c/td\u003e\n\u003ctd data-label=\"What it confirms\"\u003eCosts for each test and procedure\u003c/td\u003e\n\u003ctd data-label=\"Preparation guidelines\"\u003eUsed to distinguish checkup costs from treatment costs\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd data-label=\"Document\"\u003ePrescription, confirmation of medical care, or medical certificate\u003c/td\u003e\n\u003ctd data-label=\"What it confirms\"\u003eDiagnosis and care received\u003c/td\u003e\n\u003ctd data-label=\"Preparation guidelines\"\u003eCheck which documents the insurer accepts\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd data-label=\"Document\"\u003eTest results and medical records\u003c/td\u003e\n\u003ctd data-label=\"What it confirms\"\u003eAbnormal findings and reasons for additional tests\u003c/td\u003e\n\u003ctd data-label=\"Preparation guidelines\"\u003eSubmit if required\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd data-label=\"Document\"\u003eSurgery confirmation and similar documents\u003c/td\u003e\n\u003ctd data-label=\"What it confirms\"\u003eDiagnosis, procedure name, and surgery date\u003c/td\u003e\n\u003ctd data-label=\"Preparation guidelines\"\u003eCheck when claiming surgery benefits\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd data-label=\"Document\"\u003eMedication expense receipt\u003c/td\u003e\n\u003ctd data-label=\"What it confirms\"\u003ePrescription medication costs\u003c/td\u003e\n\u003ctd data-label=\"Preparation guidelines\"\u003eCheck when including medication costs in the claim\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\u003c/div\u003e\n\u003cp\u003eDo not treat a card transaction slip as a substitute for a medical expense receipt. Hyundai Marine \u0026amp; Fire Insurance’s guide states that card transaction slips are not accepted. It also excludes medical expense payment certificates issued for income tax deductions. \u003ca href=\"https://www.hi.co.kr/FileActionServlet/preview/1/data/202409/be11216a9ad3015a1614c313610d5200.pdf/%EB%B3%B4%ED%97%98%EA%B8%88%EC%B2%AD%EA%B5%AC%EC%84%9C%28%EA%B8%B0%EB%B3%B8%29_%EC%88%98%EC%A0%95%EB%B3%B8.pdf\"\u003eHyundai Marine \u0026amp; Fire Insurance guide to insurance claim documents\u003c/a\u003e\u003c/p\u003e\n\u003ch2\u003e\n\u003ca href=\"#how-to-file-a-claim-and-check-payment-details\" class=\"anchor\" id=\"how-to-file-a-claim-and-check-payment-details\"\u003e\u003c/a\u003eHow to file a claim and check payment details\u003c/h2\u003e\n\u003cp\u003eCheck your policy, then separate out the additional medical expenses when filing your claim.\u003c/p\u003e\n\u003col\u003e\n\u003cli\u003eCheck your insurance policy for your indemnity insurance and surgery rider coverage.\u003c/li\u003e\n\u003cli\u003eIdentify checkup items and additional medical care items in the itemized medical expense statement.\u003c/li\u003e\n\u003cli\u003eAsk your insurer which supporting documents are needed and how to file.\u003c/li\u003e\n\u003cli\u003eSubmit through the channel provided, such as the insurer’s app or website.\u003c/li\u003e\n\u003cli\u003eCheck the payment details for excluded items and how your out-of-pocket share was applied.\u003c/li\u003e\n\u003c/ol\u003e\n\u003cp\u003eIf the payout is lower than expected, first request the calculation details. Even covered expenses may be reduced by deductions specified in the policy. Having multiple indemnity insurance policies does not allow you to receive more than your actual loss. \u003ca href=\"https://product.samsungfire.com/v2/html/customer/07/F_070_010_019.html?show-element=mmList\"\u003eSamsung Fire \u0026amp; Marine Insurance explanation of indemnity reimbursement\u003c/a\u003e\u003c/p\u003e\n\u003cp\u003eIf payment is denied, check the applicable policy provisions and the specific reasons. If additional documents are needed, confirm what was requested and provide them. Samsung Fire \u0026amp; Marine Insurance’s payment procedure guide includes a process for reviewing the calculation details. \u003ca href=\"https://m.samsungfire.com/download/claim/insurance_bill%28group2%29.pdf\"\u003eSamsung Fire \u0026amp; Marine Insurance guide to insurance payment procedures\u003c/a\u003e\u003c/p\u003e\n\u003ch2\u003e\n\u003ca href=\"#common-mistakes-in-health-checkup-expense-claims\" class=\"anchor\" id=\"common-mistakes-in-health-checkup-expense-claims\"\u003e\u003c/a\u003eCommon mistakes in health checkup expense claims\u003c/h2\u003e\n\u003cp\u003eAvoid treating the total checkup cost and additional treatment costs as the same category.\u003c/p\u003e\n\u003cul\u003e\n\u003cli\u003eDo not assume that all costs, including the basic checkup fee, are covered after polyp removal.\u003c/li\u003e\n\u003cli\u003eDo not judge coverage solely by the test name, such as ultrasound or MRI.\u003c/li\u003e\n\u003cli\u003eDo not assume that having a biopsy also entitles you to a surgery benefit.\u003c/li\u003e\n\u003cli\u003eCheck which alternative documents are accepted before obtaining a medical certificate.\u003c/li\u003e\n\u003cli\u003eDo not calculate your expected payout by multiplying the surgery benefit by the number of polyps.\u003c/li\u003e\n\u003c/ul\u003e\n\u003ch2\u003e\n\u003ca href=\"#what-is-the-deadline-for-filing-an-insurance-claim\" class=\"anchor\" id=\"what-is-the-deadline-for-filing-an-insurance-claim\"\u003e\u003c/a\u003eWhat is the deadline for filing an insurance claim?\u003c/h2\u003e\n\u003cp\u003eUnder Article 662 of the Commercial Act, the limitation period for an insurance claim is \u003cstrong\u003e3 years\u003c/strong\u003e. This is also confirmed in the Commercial Act effective September 10, 2026. If you do not exercise your right to claim, it expires when the limitation period ends. \u003ca href=\"https://www.law.go.kr/lsLinkCommonInfo.do?lsJoLnkSeq=1017094811\"\u003eNational Law Information Center: Commercial Act, Article 662\u003c/a\u003e\u003c/p\u003e\n\u003cp\u003eThe date the limitation period starts must be checked for each individual claim. For older medical expenses, ask your insurer about the treatment date and the period in which you can file a claim. If the deadline is unclear or disputed, consider seeking legal advice.\u003c/p\u003e\n","tags":["Insurance claim","Everyday Finance","Health Screening"],"faqs":[{"question":"Can I claim reimbursement under medical expense insurance for national health screenings or company health checkups?","answer":"Basic preventive screening costs are generally not covered. If you received additional tests or treatment because of abnormal findings, those costs will be reviewed separately."},{"question":"If a polyp is removed, can I be reimbursed for the full screening cost?","answer":"The entire basic screening cost does not become eligible for coverage. Covered medical expenses, such as polyp removal, are identified and reviewed separately."},{"question":"Can I also claim reimbursement under medical expense insurance for sedation during an endoscopy?","answer":"Sedation chosen for a preventive screening is generally not covered. Whether the sedation or anesthesia costs were necessary for treatment must be checked against the details of the care provided and your policy terms."},{"question":"Can I also submit claims for ultrasound and MRI scans I chose as part of a screening?","answer":"Preventive screening items you chose yourself are generally excluded. For additional tests prompted by abnormal findings, medical necessity and the scope of coverage are checked."},{"question":"If follow-up monitoring is recommended, will the cost of the next test also be covered?","answer":"Coverage is not determined solely by the wording “follow-up monitoring.” The reason the doctor ordered the test during subsequent care must be checked."},{"question":"Can I claim both medical expense insurance benefits and surgery insurance benefits for polyp removal?","answer":"You can claim both if the conditions for each type of coverage are met. Check the details of your surgery benefit rider and whether the procedure actually performed qualifies as surgery."},{"question":"Are surgery benefits paid even if I only have a biopsy?","answer":"A biopsy for diagnosis must be distinguished from an excision for treatment. Surgery benefit policy terms may exclude biopsies."},{"question":"Is it enough to submit only a card receipt?","answer":"Do not assume that a card transaction slip can replace a medical expense receipt. Ask the hospital to issue a medical bill and receipt."},{"question":"Is a medical certificate always required for a medical expense insurance claim?","answer":"Not every claim requires a medical certificate. Ask your insurer whether a prescription, confirmation of medical care, or another document can be used instead."},{"question":"If I have multiple medical expense insurance policies, will I receive benefits multiple times?","answer":"Medical expense insurance does not reimburse more than the actual loss. If you have multiple policies, the insurers share the reimbursement amount according to the policy terms."},{"question":"Can I also claim treatment costs incurred during a past screening?","answer":"Under the Commercial Act, the limitation period for insurance claims is 3 years. For past medical expenses, check both the coverage in effect at the time and the limitation period for each individual claim."}],"sources":[{"url":"https://kbthink.com/insurance/claims/medical-checkup.html","title":"KB Kookmin Bank, KB's Thoughts, Can You File an Indemnity Insurance Claim for a Health Screening?, June 26, 2026","type":"source"},{"url":"https://www.lina.co.kr/cms/upload/upload/docs/disclosure/B00351002_0_P.pdf","title":"LINA Life Non-Participating Worry-Free Health Screening Mini Insurance Policy Terms and Conditions","type":"source"},{"url":"https://www.hi.co.kr/FileActionServlet/preview/1/data/202409/be11216a9ad3015a1614c313610d5200.pdf/%EB%B3%B4%ED%97%98%EA%B8%88%EC%B2%AD%EA%B5%AC%EC%84%9C%28%EA%B8%B0%EB%B3%B8%29_%EC%88%98%EC%A0%95%EB%B3%B8.pdf","title":"Hyundai Marine \u0026 Fire Insurance Guide to Insurance Claim Documents, Illness and Injury","type":"source"},{"url":"https://product.samsungfire.com/v2/html/customer/07/F_070_010_019.html?show-element=mmList","title":"Samsung Fire \u0026 Marine Insurance Good Insurance Dictionary, Compensation for Actual Losses and Pro Rata Compensation Under Multiple Policies","type":"source"},{"url":"https://m.samsungfire.com/download/claim/insurance_bill%28group2%29.pdf","title":"Samsung Fire \u0026 Marine Insurance Group Accident Insurance Claim Form and Guide to the Claims Payment Process","type":"source"},{"url":"https://www.law.go.kr/lsLinkCommonInfo.do?lsJoLnkSeq=1017094811","title":"Korean Law Information Center, Article 662 of the Commercial Act, effective September 10, 2026","type":"source"}],"images":[{"id":2708,"url":"https://injoys.com/rails/active_storage/blobs/proxy/eyJfcmFpbHMiOnsiZGF0YSI6NDE1OTIsInB1ciI6ImJsb2JfaWQifX0=--2b8644135f9ff6c50d25bba2876b80dc8341aa94/ai-46438eba.webp","is_representative":true,"generation_method":"ai_photo","license":"ai_generated","mime_type":"image/webp","width":1536,"height":1024,"translations":{"ko":{"alt":"병상에 앉은 여성이 대장 모형의 용종을 가리키는 의사의 설명을 듣고 있다.","caption":"용종 제거 비용은 실손보험과 수술비 특약의 보장 조건을 각각 확인해야 합니다.","description":null},"en":{"alt":"A woman sits in a hospital bed as a doctor points to a polyp on a colon model.","caption":"Coverage for polyp removal must be checked separately under medical expense insurance and surgery benefit riders.","description":null},"ja":{"alt":"病床に座る女性が、大腸模型のポリープを指す医師の説明を聞いている。","caption":"ポリープ切除費用は、実損填補型医療保険と手術給付特約それぞれの保障条件を確認する必要があります。","description":null},"es":{"alt":"Una mujer sentada en una cama de hospital escucha a un médico que señala un pólipo en un modelo de colon.","caption":"La cobertura de la extirpación de pólipos debe revisarse por separado en el seguro de gastos médicos y la cláusula adicional de cirugía.","description":null},"id":{"alt":"Seorang perempuan duduk di ranjang rumah sakit saat dokter menunjuk polip pada model usus besar.","caption":"Ketentuan pertanggungan pengangkatan polip perlu diperiksa secara terpisah pada asuransi biaya medis dan manfaat tambahan operasi.","description":null},"pt":{"alt":"Uma mulher sentada numa cama hospitalar ouve um médico que aponta um pólipo num modelo de cólon.","caption":"A cobertura da remoção de pólipos deve ser verificada separadamente no seguro de despesas médicas e na cobertura adicional de cirurgia.","description":null},"zh-hant":{"alt":"一名女子坐在病床上，聆聽醫師指著大腸模型上的息肉進行說明。","caption":"息肉切除費用須分別確認實支實付醫療保險與手術給付附約的保障條件。","description":null},"de":{"alt":"Eine Frau sitzt im Krankenhausbett, während ein Arzt auf einen Polypen an einem Dickdarmmodell zeigt.","caption":"Für die Polypenentfernung sind die Leistungsbedingungen der Krankheitskostenversicherung und des OP-Zusatzbausteins getrennt zu prüfen.","description":null}}},{"id":2709,"url":"https://injoys.com/rails/active_storage/blobs/proxy/eyJfcmFpbHMiOnsiZGF0YSI6NDE1OTksInB1ciI6ImJsb2JfaWQifX0=--82d317f36f616db89c76b4472ca53b363cbf9181/ai-a06aa9b7.webp","is_representative":false,"generation_method":"ai_semi","license":"ai_generated","mime_type":"image/webp","width":1536,"height":1024,"translations":{"ko":{"alt":"진료실 침대에 누운 고령 남성의 복부에 초음파 검사를 하는 의사","caption":"추가 검사비의 실손보험 보장 여부는 이상 소견과 검사의 의학적 필요성을 확인해 심사합니다.","description":null},"en":{"alt":"A doctor performs an abdominal ultrasound on an older man reclining on an examination bed.","caption":"Coverage for follow-up tests is assessed based on abnormal findings and medical necessity.","description":null},"ja":{"alt":"診察台に横たわる高齢男性の腹部に超音波検査を行う医師","caption":"追加検査費用の実損医療保険での補償可否は、異常所見と検査の医学的必要性に基づいて審査されます。","description":null},"es":{"alt":"Un médico realiza una ecografía abdominal a un hombre mayor recostado en una camilla.","caption":"La cobertura de pruebas adicionales se evalúa según los hallazgos anormales y la necesidad médica.","description":null},"id":{"alt":"Dokter melakukan USG perut pada pria lanjut usia yang berbaring di ranjang pemeriksaan.","caption":"Cakupan biaya pemeriksaan lanjutan dinilai berdasarkan temuan abnormal dan kebutuhan medis.","description":null},"pt":{"alt":"Um médico realiza uma ultrassonografia abdominal em um homem idoso deitado em uma maca.","caption":"A cobertura de exames adicionais é avaliada com base nos achados anormais e na necessidade médica.","description":null},"zh-hant":{"alt":"醫師為躺在診療床上的年長男性進行腹部超音波檢查","caption":"追加檢查費用是否納入實支實付醫療保險理賠，須依異常發現及檢查的醫療必要性審核。","description":null},"de":{"alt":"Ein Arzt führt bei einem älteren Mann auf einer Untersuchungsliege einen Bauchultraschall durch.","caption":"Die Kostenübernahme für Folgeuntersuchungen wird anhand auffälliger Befunde und medizinischer Notwendigkeit geprüft.","description":null}}}],"published_at":"2026-11-11T14:30:06+09:00","updated_at":"2026-11-11T14:30:06+09:00","license":"cc_by","translation_status":"reviewed","available_locales":["ko","en","ja","es"],"data_locales":["ko","en","ja","es","id","pt","zh-hant","de"],"url":"https://injoys.com/en/articles/health-checkup-insurance-coverage-and-claim-documents"}