NAATI CCL Korean Insurance & Claims Practice Dialogues — Worked Examples

Good afternoon. I'm calling about the car accident claim you submitted online yesterday.

네. 사고가 이틀 전에 났고 차를 운전할 수 없는 상태예요. 수리 중 대차가 제공되나요?

Your policy includes rental car cover. You're covered for up to eighty dollars a day for a maximum of fourteen days. You can go directly to an authorised rental company.

사고 과실 비율은 어떻게 되나요? 상대가 빨간 신호를 무시했거든요.

A police report and dashcam footage make it easier to establish fault. If the other party is at fault, their insurer covers your costs including repairs and the rental car.

블랙박스 영상은 있지만 경찰 보고서는 아직이에요.

Police reports take two to four weeks. Meanwhile, back up your dashcam footage — save copies to your computer and email them to yourself as a backup.

차가 전손이면 어떻게 되나요?

If repair cost exceeds the car's market value, it's classified as a total loss. You'd receive the market value minus the excess, and the car becomes the insurer's property.

부상 치료비도 보장되나요? 목이 아파요.

Yes, your policy includes up to five thousand in personal injury cover. See a doctor and keep all receipts and medical reports. These are needed for the injury claim.

내일 의사에게 가고 인증 정비소에도 차를 가져갈게요. 블랙박스 영상은 백업했어요.

Good morning. I'm the claims assessor. I'm here to inspect the storm damage you reported.

네, 들어오세요. 나뭇가지가 떨어져 지붕이 부서지고 물이 실내에 들어왔어요. 거실 천장과 벽지가 손상됐어요.

I'll photograph and document the extent of the damage. Was any furniture or electronics damaged?

소파가 물에 젖어 못 쓰게 됐어요. TV도 물이 들어가 고장났어요.

Contents are covered under your contents insurance. Whether you receive the replacement value or a brand-new item depends on the type of policy. Do you have purchase receipts or credit card statements?

소파는 3년 전 2,000달러에 샀고 영수증 있어요. TV는 1년 전 1,500달러로 카드로 샀어요.

Your policy is a new-for-old type. That means you're paid the cost of replacing the item with an equivalent new one, not its current market value. That's very favourable for you.

자기부담금은 얼마인가요?

The excess for storm damage is five hundred dollars. However, the roof, furniture, and television are separate claims. Total payout depends on individual item assessments.

수리에 얼마나 걸리나요?

Roof repairs usually take one to two weeks, but after a major storm there's high demand. I'll prioritise an emergency tarp to prevent further water damage in the meantime.

인증 업자로 부탁해요. 최대한 빨리 수리를 시작하고 싶어요. 비 오기 전에 지붕만이라도 먼저요.

Welcome. You're thinking about upgrading your health insurance. What prompted this?

아내가 임신 중인데 현재 플랜에서 임신이나 사립 병원이 보장되지 않는다는 걸 알았어요.

An important point — private hospital pregnancy cover usually has a twelve-month waiting period. That means even if you upgrade now, it may not apply to this pregnancy.

그건 몰랐어요. 그래도 공립 병원 출산은 보장되나요?

Under Medicare, childbirth in a public hospital is fully covered. Even without private insurance, you'll receive good medical care. Private only adds a choice of doctor and room.

향후 임신을 대비해 업그레이드할 가치가 있나요?

If you're planning a private hospital birth in future, upgrading now starts the waiting period. Most insurers have a twelve-month wait for pregnancy-related claims.

메디케어 리베이트가 뭔가요?

The government rebate covers part of your premium. The rate depends on your income and age. Lower income earners receive a higher rebate — up to about twenty-five per cent.

치과와 안과도 보장받고 싶어요.

Dental and optical are included in extras cover. Bundling extras with hospital cover gives you a discount. Compare the annual limits and waiting periods to choose the best plan.

이번엔 공립에서 출산하고 향후를 위해 업그레이드할게요. 치과와 안과 포함 플랜 견적을 부탁합니다.

You're calling about a medical expenses claim from an overseas trip. Can I have your policy number?

안타깝게도 발리에서 식중독에 걸려 병원에 입원했어요. 상황을 설명하고 보험 번호를 확인해도 될까요?

I'm sorry to hear that. Let me check your policy's medical cover limit. Your plan covers up to fifty thousand dollars in overseas medical expenses per trip.

병원에서 4,000달러를 직접 냈어요. 환급되나요?

Yes, once you submit the receipts and medical records, you'll be reimbursed. For overseas emergency medical treatment, the excess often doesn't apply. Your policy waives the excess for emergency hospitalisation.

귀국편을 변경해야 했어요. 항공편 변경 비용도 보장되나요?

If the flight was changed for medical reasons, the change fee and fare difference are covered. A medical certificate confirming you were unfit to fly is required.

청구 절차는 어떻게 하나요?

Complete the claim form online and upload the receipts, medical records, doctor's certificate, and flight change receipt. Once all documents are submitted, reimbursement usually takes ten to fifteen business days.

여행보험은 매번 사야 하나요? 연간 플랜이 더 이득인가요?

If you travel overseas more than twice a year, an annual plan is better value. A single-trip policy costs about a hundred and fifty, while an annual plan is around three hundred.

앞으로 연간 플랜으로 할게요. 이번 청구 서류를 오늘 중 온라인으로 제출합니다.

Good afternoon. Your car insurance renewal is due next week. I'm calling to review the renewal details.

네, 3년째 이용하고 있어요. 하지만 갱신 보험료가 작년보다 높은 것 같아요. 왜 그런가요?

Premiums are recalculated annually based on your car's market value, rising repair costs, changes in accident rates, and the risk profile of your address. This year, repair costs have risen across the board.

보험료를 낮추는 방법이 있나요?

There are several options. Increasing your excess lowers the premium. Raising it from five hundred to one thousand dollars saves about a hundred and fifty per year. There are also low-kilometre plans and dashcam discounts.

자기부담금을 올리면 리스크가 뭔가요?

Higher excess means lower premium but more out of pocket at claim time. With a thousand-dollar excess, even a minor repair like a bumper costs you the full thousand first.

다른 보험사와 비교해 봐야 할까요?

Yes, I'd recommend comparing. Use comparison websites to get quotes from other companies, then come back and negotiate with us. Also check whether your long-term customer discount and no-claims bonus will carry over.

무사고 보너스가 뭔가요?

Your premium is discounted based on claim-free years. You've had three claim-free years, giving you a good discount. Making a claim would reset it to zero.

비교 후 결정하겠습니다. 무사고 보너스 증명서를 발급해 주세요.

You're enquiring about life insurance. Can you tell me about your family situation and what you're looking to achieve?

아내와 첫째가 막 태어났어요. 제게 무슨 일이 생기면 가족이 경제적으로 보호받길 원해요.

Excellent decision. There are several types — term life covers a set period, total and permanent disability, and trauma cover for critical illness. Which interests you most?

보장액이 얼마나 필요한가요? 어떻게 계산하나요?

A guide is to add up your mortgage, living costs until your child is independent, education costs, and any debts. For most young families, one to one and a half million is common.

월 보험료는 얼마인가요?

For someone in their early thirties, non-smoker, office job, one and a half million in term cover costs around sixty to eighty dollars per month. Premiums increase with age.

연금을 통한 보험이 싸다고 들었는데요.

Yes, premiums can be deducted from super so they don't affect take-home pay. However, this reduces your retirement savings over time. It's worth comparing both options.

수익자 지정은 어떻게 하나요?

You nominate the beneficiary when applying. Naming your spouse is most common. You can also name a trust for minor children so the payout is managed until they're adults.

정기보험과 연금 보험을 조합해서 검토할게요. 가족을 지키기 위해 올바른 선택을 하고 싶어요.

You've submitted an income protection claim for medical reasons. Can you tell me about the situation?

3개월 전에 중증 우울증과 불안 장애 진단을 받았어요. 정신과 의사가 당분간 일을 못 한다고 판단했어요.

Mental health conditions are covered by income protection insurance. Under your policy, after a thirty-day waiting period, you'll receive seventy-five per cent of your monthly salary for up to two years.

지급은 언제부터 시작되나요? 이미 3개월째 쉬고 있어요.

Once approved, payments are backdated to day thirty-one. Since you've been off for two months, you'd receive a lump sum for the period after the waiting period.

복귀하면 지급이 멈추나요? 파트타임부터 시작하고 싶은데요.

We support gradual return. If you return part-time, the policy pays the difference between your part-time income and your pre-disability income. This makes the transition easier.

필요한 서류는 뭔가요?

You'll need a psychiatrist's diagnosis, treatment plan, certificate of incapacity, payslips showing lost income, and a letter from your employer confirming your absence.

정신 건강 사유로 청구가 거절될 수 있나요?

Mental health claims aren't automatically rejected. However, pre-existing conditions at the time of taking out the policy must be disclosed. Non-disclosure could void the claim.

서류를 모아 이번 주 안에 제출할게요. 지원에 감사드려요.