Claims adjustment is an important process that objectively assesses the damage caused by an insurance accident and determines the appropriate insurance money(benefit) to be paid to insured. Granting the policyholder and others the right to appoint an independent adjuster aims to ensure the fairness of the claims adjustment process. As a result, continuous legal revisions have been made for the role of independent adjusters and to ensure the protection of the policyholder and others's right to appoint independent adjusters. In particular, the amended Article 185 of the Insurance Business Act and Article 9-16 of the Insurance Business Supervision Directive in 2024 strengthened the right of policyholders and others to appoint independent adjusters and provided clear guidelines for the insurance company's consent on the right of appointment. This paper analyzes the role of independent adjusters in the process of determining the damage and deciding the insurance money(benefit) in the event of an insurance accident, as well as recent legal amendments related to this matter. Based on this, this paper focuses on examining the scope of the right to appoint an independent adjuster and the validity of the party responsible for bearing the costs. Furthermore, this paper highlights issues in the detailed interpretation of recent legal amendments and as a solution, proposes additional revisions to the Insurance Business Supervision Directive. First, by reviewing the overall claims adjustment system, including the definition and classification of adjusters as well as related laws and regulations, this paper provides an overview of the claims adjustment system. Additionally, this paper provides a detailed examination of Article 185 of the Insurance Business Act and Article 9-16 of the Insurance Business Supervision Directive, amended in 2024. It also looks into the issues and the solutions regarding the claims adjustment system that were discussed leading up to these amendments. Next, this paper examines the interpretative issues of Article 185 of the Insurance Business Act and Article 9-16 of the Insurance Business Supervision Directive, amended in 2024. Based on the purpose and intent of the amended Insurance Business Act, Insurance Business Supervision Directive, and the previous regulations, this paper reviews the reasonable interpretation of Paragraphs 2 and 5 of Article 9-16 of the Insurance Business Supervision Directive, amended in 2024.
Ko et al. (Fri,) studied this question.
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