Recent data released by the National Health Insurance Service shows that overpayments and incorrectly billed health insurance premiums in South Korea surpassed 4조원을 돌파한 것으로 나타났다 over a five-year period, according to figures revealed by People Power Party lawmaker Baek Jong-heon.
Five-Year Overpayment Scale and Rising Trends
According to data submitted to the National Assembly’s Health and Welfare Committee by the National Health Insurance Service, total health insurance overpayments reached approximately 4조2477억원 across 1545만9000건 individual cases between 2021 and August 31 of the current year. Annual figures indicate steady upward pressure on erroneous billings: 7223억원 in 2021, 6974억원 in 2022, 6950억원 in 2023, and a sharp jump to 9306억원 in 2024. Overpayments continued at a high volume with 9386억원 recorded in 2025, alongside an additional 2638억원 accrued through August of this year. Last year’s volume marked a 29.95% increase compared to the total recorded in 2021, according to official data.
Unclaimed Refunds and Administrative Gaps
Out of the multi-trillion-won total collected over the five-year span, 455억원 remains unreturned to health insurance subscribers. Of that unclaimed pool, 382억원 sits as outstanding unreturned funds, while another 73억원 has formally lapsed and reverted to the state treasury due to expired statutory prescription periods. A breakdown of the unreturned cases shows that regional subscribers account for 41만 건 totaling 169억원, whereas workplace-based subscribers account for 13만4000건 totaling 286억원. While regional subscribers registered a higher number of uncollected cases, the total monetary value of unreturned funds was higher among workplace-based subscribers.
Causes of Erroneous Billings and Official Response
Health insurance overpayments typically occur due to duplicate or mistaken payments, retroactive loss of subscriber eligibility, adjustments to insurance premium assessment data, and subsequent retroactive premium adjustments. To manage these discrepancies, the National Health Insurance Service states that it operates multiple outreach channels—including its official website, mobile applications, and the Ministry of the Interior and Safety’s “GooPee” digital assistant service—to notify subscribers of pending refunds and process applications. However, lawmaker Baek Jong-heon pointed out that the volume of uncollected funds indicates current measures remain insufficient, arguing that the agency needs to overhaul its upfront assessment logic rather than relying exclusively on post-payment reimbursement systems.
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