Korea's digital indemnity claims: how to use Silson24

What digitised indemnity claims are

To claim on silson, Korea's indemnity health insurance that repays actual medical costs, you used to collect a receipt and an itemised bill at the hospital desk, then photograph or fax them. That hassle meant many people never claimed small bills. Digitised claims change this: at the patient's request, the provider sends the papers electronically to the insurer, so the patient no longer carries them. An amendment to the Insurance Business Act gave providers the duty to transmit on request, and the Korea Insurance Development Institute (KIDI) was named as the relay agency that passes the papers along. For you, the change is that the step of obtaining papers disappears. The insurer still assesses and pays, and the policy's coverage and deductibles stay the same. So digitisation does not pay more; it changes the route the claim papers travel. General claim documents and deadlines are covered in our article on how to claim insurance; this one focuses on using the digital route in practice.

When it started and who is covered

The rollout came in two stages. In stage 1, from 25 October 2024, hospitals with 30 or more beds and public health centres were covered. In stage 2, from 25 October 2025, clinics and pharmacies joined, bringing in effectively all medical providers (as announced by the Financial Services Commission). But being covered by law does not mean every provider can transmit at once. The provider's software must be connected to KIDI's system, and this linking proceeds at different speeds. Official figures showed a low connection rate among clinics and pharmacies right after stage 2 began. So what matters is not whether your provider is covered on paper but whether it is actually connected now. Connection numbers keep changing, so rather than remembering a figure, check each time you claim. Scope and schedule may change as the system is refined, so check the Financial Services Commission and KIDI.

• Stage 1 (25 Oct 2024): hospitals and public health centres
• Stage 2 (25 Oct 2025): clinics and pharmacies
• Covered by law still requires a system connection
• Check connection status when you claim

How to claim in Silson24

The main channel is Silson24, the app and website run by the Korea Insurance Development Institute (KIDI); some insurer and hospital apps also connect to it and pass claims along the same route. Whichever you use, papers travel via KIDI to the insurer. First log in with identity verification and confirm the person claiming and their indemnity policies. Next choose the provider and treatment date to load records; for a connected provider, the receipt and itemised bill appear in the list. Then choose the insurer to receive them, enter the payout account and details such as how the injury happened, and send. If you hold indemnity cover with two or more insurers, select all of them so each assesses its share. Assessment and payment are then the insurer's job, so check the outcome in its app or by text, and note the submission number and date. Do not tap links in texts offering 'easy claims' or use look-alike apps; download from the official app store after checking the operator.

• Log in with identity verification
• Pick provider and date to load records
• Select insurers to receive them (all if several)
• Enter account and details, then send
• Check the payout with the insurer

Extra papers may still be needed

What providers send through the digital route are mainly the basic indemnity papers: the receipt, the itemised bill and the prescription. If the insurer judges it necessary, though, it can ask for more. For a large claim, to confirm whether a non-covered treatment was needed, or where a diagnosis name matters, you may be asked for a medical certificate or doctor's opinion. Cases tied to other compensation, such as car accidents or work injuries, may need related documents too. These extras may fall outside the digital route, so you obtain them from the provider and upload them yourself, for example in the insurer's app. So do not treat sending as the end; keep a step to check whether the insurer has asked for anything more. If you ignore such a request, the assessment can sit idle while time passes. Which papers are transmitted depends on the connection scope and the insurer's standards, so follow the app's guidance.

Example: one treatment, linked and unlinked providers

The following is a hypothetical example. Suppose a sore shoulder takes you to an orthopaedic clinic three times, and you fill the prescription at a nearby pharmacy. Assume Silson24 shows the clinic is connected but the pharmacy is not yet. The three clinic visits can be loaded in Silson24 and sent to your insurer. The pharmacy bill cannot go digitally, so you get the receipt there and upload a photo in the insurer's app, the old way. Insurers usually assess papers from both routes together as one event, but noting that they belong to the same treatment avoids confusion. If you have indemnity cover with two insurers, select both in Silson24 for the clinic visits, and send the pharmacy receipt to each insurer yourself. Knowing that connection status can differ between providers even for one course of treatment helps you avoid missed claims. Actual handling depends on each provider's connection and the insurer's standards.

Common misconceptions

A new system brings misconceptions. The most common is that benefits will arrive automatically. Papers are sent only when you request it, so nothing happens unless you claim in an app. The worry that providers hand all your medical records to insurers is also inaccurate. What is sent is the claim papers for treatments you choose, and the law bars the relay agency from using information it obtains in its work for other purposes. Assuming any provider covered by law can transmit may also be wrong: a provider not yet connected cannot send even if covered. Finally, there is no basis for the idea that digital claims face tougher assessment. Assessment follows the policy terms, and coverage does not change with the claim route.

• Automatic payment: you must request it
• All records shared: only papers for chosen treatments
• Covered means ready: a connection is still needed
• Digital claims judged differently: the terms decide

Checklist before a digital claim

When you have a treatment to claim, check in this order. First, look up in Silson24 or similar whether the provider is connected. If it is, choose the date and provider and see whether papers appear. Right after a visit they may not be ready yet, so if nothing shows, look again a few days later or ask the provider. Select every insurer where you hold indemnity cover; if you have both an employer's group policy and a personal one, both may apply. After sending, record the result and date, and watch for requests for extra papers. Collect visits to unconnected providers separately and claim them the usual way. Keeping these two tracks apart reduces missed claims.

• Check the provider's connection status
• See whether records appear in the list
• Select every insurer with indemnity cover
• Record result and date; watch for requests
• Claim unconnected visits the usual way

Common case 1: no treatment records show up

Sometimes you clearly had treatment but Silson24 shows nothing. The most common reason is that the provider is not yet connected. Check its status in the provider search; if it is not connected, obtain the papers and claim directly as before. If it is connected but nothing shows, the papers may not be ready just after the visit, or the treatment date may predate the connection and fall outside transmission. Check whether the search period is set too narrowly. If it still fails, telling the provider's billing desk you want to claim digitally and asking about the status is the quickest fix. Waiting lets time slip, and an indemnity claim can lapse under the 3-year limitation period, so do not postpone the claim because the digital route is blocked; filing the usual way is safer. There is little reason to wait for digital transmission to become possible.

Common case 2: how far does the data consent go

A digital claim takes you through several consent screens. Generally they cover processing for identity checks, the provider sending your claim papers via the relay agency to the insurer, and the insurer using them to assess the benefit. The usual structure is consent for claims on the treatments you chose, not a blanket handover of all future records. Screens may mix required and optional items, though; if an optional one concerns marketing or sharing with third parties unrelated to the claim, see whether the claim proceeds without it. Claiming through a private platform may add that platform's own consents. Consents can often be withdrawn later, so look in the app's settings. If the insurer, during assessment, asks for separate consent to view medical records, that is a different procedure from the digital claim, so check its scope on its own.

Limits and disclaimer

This article explains the general structure and use of Korea's digitised indemnity insurance claims; it is not legal or insurance advice on any specific contract. The rollout dates follow Financial Services Commission announcements, while the range of connected providers, app screens, types of papers transmitted and insurers' standards for extra papers differ by time and company and may change as the system is refined. Rules can change from year to year, so before claiming check official guidance from Silson24, KIDI, your insurer and the Financial Supervisory Service. Whether and how much you are paid is set by your policy terms, regardless of digitisation. If a claim is refused or reduced, get the reasons in writing and consider official routes such as dispute mediation by the Financial Supervisory Service. Treat anyone offering to claim for you in exchange for a fee or personal data with suspicion, and do not tap unknown links. If unsure, ask your insurer's customer centre or the Financial Supervisory Service.