Supreme Court rules on National Health Insurance subrogation claims

The Supreme Court dismissed an appeal in a subrogation case involving the National Health Insurance Service. The ruling clarifies that when the insurer seeks reimbursement from a tortfeasor or their liability carrier after paying benefits to a victim, payments already made to the victim under liability policies cannot be simply deducted from the amount owed to the public fund.

The service may exercise subrogation rights only within the scope of damages calculated after considering factors such as the victim's negligence. Compensation paid directly to the victim by the liable party or their insurer after public health benefits were issued cannot be subtracted from the subrogation claim.

Subrogation rights are limited to damages arising from the same cause as the insurance benefits, meaning the two forms of compensation must be complementary for the claim to be extinguished. When a liability insurer has paid amounts covering damages that are not complementary to the health benefits, those specific sums must be deducted from the total liability payment owed to the service.

In cases where it is impossible to specifically identify which part of the payment corresponds to non-complementary damages, the deductible amount should be calculated based on the ratio of such damages to the victim's total losses.

The case, identified as 2025Da210218, was a civil suit concerning claim money.