Required Documents
Required Documents
-
Mediation
application form
-
Copy of ID
-
A copy of
your bankbook
-
Mediation
(arbitration)
Application sheet
-
Agreement on
collection of sensitive
personal Information
Additional documents
The following additional documents may be required for professional appraisal and
mediation tasks and rapid relief:
- The following additional documents may be required for professional appraisal and mediation tasks and
rapid relief:
- Proof of income
- Video (MRI, X-ray, etc.)
- Before and after surgery
- Receipt of medical expenses
- Other related materials
Other related materials
Other related materials
division |
shape |
Applicant |
document |
patient |
If the patient is an adult |
a copy of his |
her ID card |
If the patient is a minor |
a Family Relation Certificate with a legal guardian (parental guardian) |
If the patient cannot express his/her own wishes |
the guardian (after July 2013, adult guardian or limited guardian) Guardian selection
certificate |
If deceased (including death of the patient), |
a family relationship certificate with regard to the heir (the actual person) |
fetal death |
Birth certificate for pregnant mother (the actual person) in case of fetal death |
Proxy application (family relationship) |
Agent family relationship certificate· Authorized seal certificate· Power of attorney
|
Proxy application (without family relationship) |
Agent representative |
Authorized seal certificate · Power of attorney |
Medical Institutions |
Representative of a corporation of a medical institution |
Permission of corporation registration or establishment of medical institution ·
Representative ID |
Private hospital medical institution |
Copy of medical ID |
Copy of the ID of the medical personnel belonging to the medical
institution |
Proxy applicant |
Attorney seal certificate, attendance |
Common Attorney |
Representative Attorney |
If the required documents are missing, the Korea Medical Mediation and Arbitration
Agency may ask the applicant to supplement the data, or the application may be dismissed.