South Korea’s Health Insurer Seizes More, Collects Less: The Numbers Behind the Gap
Health insurance data from South Korea shows seizures rising even as actual collections remain lower. The numbers reveal the growing gap between enforcement and recovery.
Health insurance in South Korea is seeing a widening gap between amounts seized and actual collections.
Health Insurance: South Korea’s National Health Insurance Service (NHIS) seized 1,682,861 properties from premium delinquents in 2025, up 67% from 1,005,354 in 2021, according to data the agency submitted to the National Assembly in September 2026. Over the same period, revenue the NHIS actually recovered through enforcement fell by nearly half.
The figures were obtained by Assemblyman Seo Youngseok of the Democratic Party and first reported by The Asia Business Daily. They point to a growing disconnect between how many assets the NHIS is seizing and how much of that seized value it is turning into collected premiums.
Health Insurance: Deposits dominate seizures as real estate auctions stall
Deposit seizures accounted for 78.3% of total seized assets in 2025, up from 66.4% in 2021, the data shows. Real estate seizures moved in the opposite direction, falling from 52,532 cases in 2021 to 39,975 in 2025 — a 24% drop — with the real estate seizure rate declining from 5.2% to 2.4%.
Few of those real estate seizures ever reach auction. In 2021, the NHIS filed 134 auction requests out of 52,532 seizures, a conversion rate of 0.26%. In 2025, that was 114 requests out of 39,975 seizures, or 0.29%. Revenue recovered through public auction dropped from 1.2 billion won in 2021 to 660 million won in 2025, a decline of approximately 45%.
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The NHIS attributed the low conversion rate to prior liens on seized properties and insufficient surplus value after existing claims are settled, factors that can block an auction even after a seizure is legally completed.
Health Insurance: Most named delinquents own no property, but a small group owns hundreds
Of the 10,444 habitual delinquents the NHIS publicly named in 2025, 8,087 — or 77.4% — owned no property at all, according to the disclosed data.
Among the remainder, ownership was concentrated in a small number of individuals with large real estate holdings. Delinquents owning more than 30 residential properties rose from six in 2022 to 37 in 2025. Those owning more than 100 properties grew from one to nine over the same period. The single largest holder among named delinquents owned 764 residential units; other top holders owned 316, 231, 226 and 180 units respectively.
Assemblyman Seo said the pattern points to a gap in targeted enforcement. “As the number of habitual delinquents with dozens or hundreds of homes whose personal information is being made public increases, there is a need for more thorough collection management targeting high-value and habitual delinquents with the clear ability to pay,” he said. He also called on the NHIS to audit the causes of low auction conversion by category, to determine how many cases are blocked specifically by insufficient surplus or prior claims.
Health Insurance – A collection gap inside a wider fiscal squeeze
The enforcement shortfall comes as the NHIS fund’s finances have deteriorated. The fund’s current account surplus fell 88% between 2023 and 2025, from 4.1 trillion won to 499.6 billion won, according to NHIS fiscal results. Insurance benefit spending rose 8.4% in 2025 while total revenue grew only 3.8%.
In the first quarter of 2026, the fund recorded a deficit of approximately 3.9 trillion won, with revenue of 22.4 trillion won against spending of 26.3 trillion won, The Korea Times reported. The fund’s cumulative reserve fell from 30.2 trillion won at the end of 2025 to 26.3 trillion won. The Health Ministry had projected an annual net loss for 2026 as early as February 2024.
NHIS president Jung Ki-suck said earlier this year that the service would “strengthen the financial soundness of the health insurance system through rigorous expenditure management” despite the projected 2026 deficit, according to Korea BioMed Review.
A longer-range study published in Health Economics Review in November 2025, drawing on NHIS financial data and Statistics Korea population projections, found the fund’s accumulated reserves are projected to be depleted by 2030, with annual deficits growing from 21.8 trillion won in 2032 to 123.3 trillion won by 2042.
Relevance to private insurers: The OECD’s Health at a Glance 2025 Korea country note found that only 60% of health spending in South Korea is covered by mandatory prepayment schemes, compared with a 75% average across OECD countries. GlobalData forecasts personal accident and health insurance in South Korea to grow at a CAGR of 9.3% between 2025 and 2029. The Financial Supervisory Service reported that indemnity health insurance posted a loss of 1.87 trillion won in 2025, and the Life and General Insurance Association of Korea announced a weighted average premium increase of approximately 7.8% for indemnity products in 2026, with some fourth-generation policyholders facing increases of around 20%.
