This content has been prepared in compliance with relevant laws including the Medical Service Act.
Around four weeks after a traffic accident, many people receive calls from insurance companies asking them to "submit a diagnostic certificate." If you were startled by this sudden request, this article will walk you through the procedure step by step. To put it plainly, those who fall into the category of minor injuries (grades 12-14) must submit an additional diagnostic certificate to the insurance company if they wish to continue treatment even after four weeks from the date of the accident. If you do not submit it, the insurance company's payment guarantee may be terminated, so it is important to prepare for it in advance right before the 4-week period expires.
Do You Really Have to Submit a Diagnostic Certificate 4 Weeks After a Traffic Accident? — Key Summary
Immediately after an accident, treatment cost payment guarantee is provided without special documents, but for those falling under the minor injuries category (grades 12-14), that period is limited to four weeks (28 days) from the date of the accident. According to AXA Auto Insurance official policy guidance, following the policy revision effective January 1, 2023, if a minor injury patient wishes to receive treatment beyond four weeks, an additional diagnostic certificate must be submitted, and the payment guarantee for treatment is extended according to the diagnostic period stated in the certificate.
In other words, if pain in the neck or lower back remains even after four weeks have passed, you cannot simply continue visiting the clinic as usual; you must first go through a additional diagnostic certificate documentation procedure.
There is one important distinction. Those classified as grades 11 and above (moderate to severe injuries) do not have this 4-week rule applied and have no obligation to submit an additional diagnostic certificate. You can check your injury grade on the insurance company's application confirmation document, so it's good to verify this first.
Reactions may differ depending on constitution and symptom severity. Even for the same accident, treatment duration and progress may vary depending on the individual's health status and nature of injuries.
Why the 4-Week Diagnostic Certificate Emerged — Background of Auto Insurance Policy Revision and Procedural Mechanism
Before 2023, there were cases where a single initial diagnostic certificate maintained treatment cost payment guarantee for several months. However, according to relevant materials, after the revision, a step-by-step documentation review structure was established targeting minor injury patients. According to reports from related professional media such as DentalFocus, the key background to this change was the application of the negligence responsibility principle to minor injury patients (grades 12-14) through Ministry of Land, Infrastructure and Transport Notice No. 2023-2 (Standards for Auto Insurance Medical Service Fees).
After the revision, the traffic accident treatment procedure can be understood through the following flow:
▪ 0-4 weeks (Stage 1): Payment guarantee maintained without diagnostic certificate — this is the period during which treatment costs are covered without a diagnostic certificate. During this time, keep detailed records of your symptoms.
▪ Just before 4-week expiration (diagnostic certificate submission timing): Obtain an additional diagnostic certificate and submit it to the insurance company. Payment guarantee is extended for the period stated in the certificate from the submission point onward.
▪ 7-week mark (Stage 2 deadline): To continue treatment beyond 8 weeks, separate documents must be finalized at the 7-week mark. Missing this step may make it difficult to pass extended treatment review.
▪ Beyond 8 weeks (Stage 3): A checkpoint for extended treatment review, with separate review procedures applied.
Understanding the overall roadmap of the treatment period in advance can help you avoid missing documentation deadlines.
From Diagnostic Certificate Issuance to Insurance Company Submission — Step-by-Step Practical Procedure
When the 4-week expiration date approaches, here's how to actually proceed, broken down step by step.
▪ STEP 1 — Confirm injury grade: Check your injury grade on the insurance company's application confirmation document (whether you fall under grades 12-14).
▪ STEP 2 — Request additional diagnostic certificate: Ask your attending physician at the healthcare facility where you are currently receiving treatment for "an additional diagnostic certificate for extending auto insurance treatment." The diagnostic certificate must clearly state the causal relationship with the traffic accident, treatment necessity, and expected duration of future treatment.
▪ STEP 3 — Link imaging tests (if necessary): If pain persists and initial imaging tests were insufficient, reflecting MRI or X-ray results from a partner hospital in the diagnostic certificate helps clarify the basis for treatment extension.
▪ STEP 4 — Submit to insurance company: Deliver the issued diagnostic certificate to your representative via fax, insurance company app, mail, or other methods. After that, payment guarantee is extended for the period stated in the certificate.
According to Financial Supervisory Service Consumer Notice (Joseilbo Report), if you submit the diagnostic certificate late, a portion of treatment costs beyond four weeks before the submission date may be excluded from compensation. This is why it is important to prepare with plenty of advance notice.
Korean medicine clinics can also issue auto insurance diagnostic certificates reflecting actual treatment contents such as Tuina therapy, acupuncture, and herbal medicine. Gangbuk Anjeong Korean Medicine Clinic guides patients approaching the 4-week mark during traffic accident treatment on the additional diagnostic certificate procedure, and systematically assists with establishing grounds for treatment extension through a network of partner hospitals for imaging test coordination.
Before Extending Traffic Accident Treatment, Please Check These Items First
Before the 4-week expiration, reviewing the items below will help you proceed with treatment extension review more smoothly.
| Item to Check | Verification Details |
|---|---|
| ▪ Injury grade | If 12-14 (minor injuries), subject to 4-week rule. If 11 or above, no obligation to submit additional diagnostic certificate |
| ▪ Presence of residual symptoms | Check if pain remains in neck, lower back, shoulders, etc. If symptoms exist, it serves as grounds for treatment extension |
| ▪ Outpatient visit frequency pattern | According to relevant materials, 0-3 weeks is daily, 4-11 weeks is 3 times per week, and beyond 12 weeks is 2 times per week as the standard. If the pattern becomes abruptly irregular, it may be disadvantageous in review |
| ▪ Completeness of medical records | Treatment history must be sufficiently documented for extended review to proceed smoothly |
| ▪ Imaging test history | Objective evidence such as MRI or X-ray helps with establishing causal relationship |
As the treatment period lengthens, consistency and completeness of medical records become increasingly important. The key to managing medical records is communicating the symptoms you actually experience to your healthcare provider in detail.
Residents of nearby areas such as Dobong, Nowon, and Seongbuk can also visit Gangbuk Anjeong Korean Medicine Clinic near Suyeong Station to receive the same traffic accident treatment procedures and diagnostic certificate guidance.
Where and How Should You Start Treatment After a Traffic Accident?
If you wish to continue treatment after a traffic accident but find the 4-week diagnostic certificate procedure overwhelming, Gangbuk Anjeong Korean Medicine Clinic will examine it carefully for you. Disadvantages such as payment guarantee termination due to non-submission of diagnostic certificates or partial loss of treatment costs due to late submission can be sufficiently prevented if you understand the procedure in advance.
Symptoms not documented in the early stages of an accident tend to become increasingly difficult to establish causal relationship with the accident over time. If there is any discomfort remaining in your body, it is important to document it in a timely manner without missing the opportunity.
Gangbuk Anjeong Korean Medicine Clinic operates 365 days a year starting at 8 AM, and you can easily schedule a visit through Naver reservations. From blood stasis removal following traffic accidents to individual customized herbal medicine prescriptions, Tuina therapy, and coordination with partner hospitals for imaging tests, we will examine all aspects of treatment together.
Traffic Accident 4-Week Diagnostic Certificate — These Are the Questions You Were Curious About, Right?
Q1. By when must I submit the 4-week diagnostic certificate?
You must submit it before the four-week period from the date of the accident expires. If you submit after the four weeks have already passed, a portion of treatment costs incurred during that interval may be excluded from compensation. It is safer to request an additional diagnostic certificate from your attending physician in advance during the 3rd-4th week.
Q2. Can I obtain an auto insurance diagnostic certificate from a Korean medicine clinic?
Yes, you can. Korean medicine clinics can also issue auto insurance diagnostic certificates reflecting actual treatment contents such as Tuina therapy, acupuncture, and herbal medicine. The causal relationship with the traffic accident and necessity of future treatment must be clearly stated, so you can request it from your attending physician at your current Korean medicine clinic.
Q3. What happens if I submit the diagnostic certificate late?
According to Financial Supervisory Service consumer notices, if submission of the diagnostic certificate is delayed, treatment costs incurred between the 4-week-exceeded mark and the submission date may be excluded from compensation. Additionally, if the submission deadline passes, the insurance company's payment guarantee itself may be terminated, so you must meet the deadline.
Q4. How much is treatment extended after submitting the diagnostic certificate?
As a principle, payment guarantee is extended for the expected future treatment period stated in the diagnostic certificate. For example, if the diagnostic certificate states "4 weeks of treatment is necessary," treatment costs during that period are covered. If pain persists afterward, you can request submission of an additional diagnostic certificate to extend coverage.
Q5. Can I continue treatment even after 8 weeks?
Yes, it is possible, but additional procedures apply. To receive treatment beyond 8 weeks, separate documents must be finalized at the 7-week mark, and you will then go through a review process. If extended treatment is expected, it is important to understand the 7-week deadline in advance and manage treatment progress by ensuring it is sufficiently documented in medical records.
Reactions may differ depending on constitution and symptom severity