This content has been prepared in compliance with relevant laws and regulations including the Medical Law.
If treatment is still needed even four weeks after a traffic accident, coverage does not automatically continue. Minor injury patients must submit a diagnostic certificate within the designated timeframe to maintain payment guarantee. If you proceed without knowing the procedure, you may have to bear all treatment costs for that period yourself, so from now on, carefully confirm each step in sequence.
To receive treatment cost coverage even 4 weeks after a traffic accident, you must submit a diagnostic certificate 'before the 4th week'
With the implementation of the revised auto insurance standard terms on January 1, 2023, the treatment coverage structure for minor injury patients with injury grade 12-14 has changed. According to relevant reports from the Financial Supervisory Service, minor injury patients maintain auto insurance payment guarantee without a separate diagnostic certificate for up to four weeks (28 days) from the accident date, but to continue treatment beyond 4 weeks, you must submit a diagnostic certificate issued by a medical institution to the insurance company. If you fail to submit within this deadline, payment guarantee will be suspended, and treatment costs during the unsubmitted period will not be reimbursed.
This obligation applies only to minor injury patients with injury grade 12-14. If you fall into severe injury (grade 1-11) or higher, different standards apply, so it is important to first confirm your injury grade.
📌 Key Summary
- Minor injury patients (grade 12-14) → Coverage without diagnostic certificate for up to 4 weeks after accident
- If treatment beyond 4 weeks is desired → Diagnostic certificate submission before D+28 days is mandatory
- If not submitted → No compensation for treatment costs during that period (results may vary depending on individual circumstances)
Diagnostic Certificate Submission, Proceed This Way — Step-by-Step Procedure and What Must Be Confirmed
According to reports from the Korea Insurance Research Institute (KIRI), minor injury patients requiring treatment beyond 4 weeks operate on a structure where they submit additional diagnostic certificates in 2-week intervals to extend treatment. Confirm the entire flow using the checklist below.
✓ STEP 1 — Diagnostic Certificate Issuance (Before D+28 days) Obtain a diagnostic certificate including future treatment opinions from the medical institution where you are being treated (Western medical clinic/hospital or Korean medicine clinic, both acceptable).
✓ STEP 2 — Insurance Company Submission Submit to your insurance company representative via fax or direct visit. Be sure to note the submission date and representative's name.
✓ STEP 3 — 2-Week Renewal If additional treatment is needed after the 4-week period, re-issue and re-submit diagnostic certificates in 2-week intervals before the opinion period on the diagnostic certificate expires. If you pass the opinion period, coverage gaps may occur again.
✓ STEP 4 — Claim Diagnostic Certificate Issuance Costs According to Korea Mutual Insurance News, diagnostic certificate issuance costs are in principle the responsibility of the victim (patient) according to Ministry of Land, Infrastructure and Transport standards, but you can separately claim from the other party's insurance company. Be sure to keep receipts.
Only treatment costs within the 'future treatment opinion period' stated in the diagnostic certificate are acknowledged by the insurance company. Treatment costs after the opinion period expires may not be acknowledged without a separate procedure.
If you are receiving treatment at a Korean medicine clinic — How to manage diagnostic certificates and treatment continuity at Gangbuk Anjeong Korean Medicine Clinic
If you are receiving treatment at a Korean medicine clinic after a traffic accident, you may wonder if you can obtain a diagnostic certificate. According to related legal information, Korean medicine doctors can issue diagnostic certificates within their license scope, and they are valid for submission to insurance companies.
Gangbuk Anjeong Korean Medicine Clinic (formerly Gwangdeok Anjeong Korean Medicine Clinic Gangbuk Suyu Branch) applies auto insurance to support customized herbal medicine prescriptions for blood stasis treatment and imaging test coordination (MRI·X-ray) through partner hospitals, allowing you to systematically manage treatment and diagnostic certificate issuance procedures in one place. From customized herbal medicine prescriptions for blood stasis removal within 3 weeks immediately after an accident to prescriptions of standby medications such as plasters and Chungsimwon when needed, all treatment procedures proceed under auto insurance coverage.
Additionally, even after the 20-session limit for chuna therapy is exhausted, spine and joint care continues using zero-gravity decompression equipment, so treatment can continue uninterrupted with each diagnostic certificate renewal period. To ensure no coverage gaps occur during treatment, you can receive guidance on diagnostic certificate issuance timing and procedures when you visit.
4-Week Diagnostic Certificate, Cases Where It's Absolutely Necessary and Cases to Watch Out For
According to Hankyung Magazine, injury grade 12-14 corresponds to minor injuries such as simple spine sprains and contusions. First check your situation using the table below.
| Situation | Diagnostic Certificate Required | Points to Watch |
|---|---|---|
| Injury grade 12-14 minor injury, outpatient treatment expected to exceed 4 weeks | ✅ Absolutely necessary | Strict compliance with D+28 days submission deadline |
| Injury grade 12-14 minor injury, treatment expected to conclude within 4 weeks | ❌ Not necessary | Consult medical staff immediately if symptoms worsen |
| Injury grade 1-11 (severe injury or higher) | Different standards apply | Individual confirmation needed with handling insurance company |
| Diagnostic certificate submission deadline already passed | ⚠️ Gap period may be handled at personal cost | Guarantee resumes immediately for subsequent treatment after resubmission |
The 'treatment weeks' stated in the diagnostic certificate is not an absolute upper limit of the treatable period. In clinical cases, when medical staff determines that symptom improvement is slow, additional treatment extension opinions can be obtained to receive acknowledgment of extended periods. Active communication with your medical staff is important.
Gangbuk-gu traffic accident Korean medicine clinic or Suyu Station traffic accident treatment seekers, as well as nearby residents in Dobong-gu traffic accident Oriental medicine care can also visit Gangbuk Anjeong Korean Medicine Clinic.
The longer treatment continues, the more carefully you must maintain coverage continuity
If you wish to maintain treatment coverage without gaps after an accident, please visit Gangbuk Anjeong Korean Medicine Clinic (Exit 3, Suyu Station), which opens at 8 AM 365 days a year, to receive guidance on auto insurance traffic accident treatment and diagnostic certificate procedures together.
The 4-week diagnostic certificate is not a signal to end treatment. It is an essential document to maintain treatment continuity and receive compensation for treatment costs already incurred. As specified in Financial Supervisory Service Consumer Cautions, treatment costs during unsubmitted periods are not subject to retroactive reimbursement. Only treatment costs incurred after submission are acknowledged, so it is advantageous to handle submission even a day earlier than the deadline.
Clinics are available from 8 AM not only on weekday evenings but also weekends and holidays, so you can continue your treatment flow without interruption even with a busy work schedule. By making reservations through Naver Reservation for your preferred time slot, it becomes even more convenient. During the time your body recovers after an accident, we hope you can focus on treatment without document worries.
Diagnostic Certificate Submission, Answers to Only the Confusing Parts
Q1. If a diagnostic certificate was not submitted even after 4 weeks, what happens to the treatment costs during that period?
Unfortunately, treatment costs during the unsubmitted gap period are difficult to obtain reimbursement for from the insurance company. The unsubmitted period is treated as a suspended payment guarantee, so treatment costs during that period may become your personal responsibility. However, even after the gap, if you submit a diagnostic certificate immediately, coverage can resume from that point, so it is important not to give up thinking it's too late and respond quickly.
Q2. Is a diagnostic certificate received from a Korean medicine clinic also valid with insurance companies?
Yes, it is valid. Korean medicine doctors can issue diagnostic certificates within their license scope, and they are acknowledged in auto insurance procedures. However, the diagnostic certificate must clearly state future treatment opinions and period, so inform your attending Korean medicine doctor beforehand that it is for insurance company submission.
Q3. If the diagnostic certificate shows '2-week opinion,' can I only receive 2 weeks of treatment?
No. The opinion period in the diagnostic certificate is the treatment duration the medical staff currently judges necessary from the present point, and is not an absolute treatment restriction period. If symptoms persist after 2 weeks, you can consult with medical staff, obtain additional opinions, and re-issue and re-submit the diagnostic certificate to continue treatment.
Q4. Should I pay for diagnostic certificate issuance, or should the insurance company pay?
According to Ministry of Land, Infrastructure and Transport standards, diagnostic certificate issuance costs are in principle initially borne by the victim (patient). However, if you keep the issuance receipt, you can separately claim from the other party's insurance company. If the claiming method is unclear, first check with your handling insurance company representative whether diagnostic certificate issuance costs can be claimed.
Results may vary depending on individual circumstances