My actual cost insurance has a limit of 50 million won when hospitalized, and the deductible amount is separate regardless of salary or non-benefit. For example, if the amount is 500, the entire 500 is refunded. This is because it is old insurance.

They say it's different from recent insurance that refunds 80~90%.

Anyway...
 

I have a question. The problem is this... There are
 three major types of rhinitis surgery
 : nasal septum deviation (covered), lower turbinate (covered), and nasal valve (
 
not

 covered). Nasal septal deviation and lower turbinate are covered by the law, so it will be covered by the law, but in the case of the nasal valve, it is not covered by the law, so post-surgery documents are required. At the time of submission, the compensation manager
 said that payment may be excluded
 if they determine that it is for cosmetic purposes .

So,
 cut off the documents and submitted them.
The insurance compensation manager also asked what criteria they used to make the decision. They only vaguely say that they will make a decision after receiving the documents. It is said that refunds are only made upon treatment.
​Of course, you receive a refund at the time of treatment, and
 you also receive a medical opinion.
However , I don't understand why
 the compensation manager receives the documents and then
 makes a separate decision as to whether it is for cosmetic purposes or treatment purposes
 . ​I underwent surgery for treatment purposes, and all CT findings were judged, but
 the compensation manager draws a line saying that this was not for treatment purposes, and
 unfairly refuses to pay.
 In this case, if the insurance company unfairly
 refuses payment, what should I do about reporting procedures?
Does anyone know?