In 2013, a no-fault compensation system was introduced for unavoidable medical accidents. Under this system, the government provides compensation for obstetric accidents that occur despite healthcare professionals fulfilling their duties of care.

At the time of implementation, funding was shared between the maternity hospitals (30%) and the state (70%), and the maximum compensation amount was set at 30 million KRW. However, persistent criticism arose because of the low compensation level and the excessive burden imposed on maternity hospitals when obstetric facilities rapidly disappeared.

Starting in 2025, the government revised the system to support the obstetric infrastructure by assuming 100% financial responsibility and increasing the compensation limit to 300 million KRW. Additionally, the gestational age threshold for eligibility was relaxed to 32 weeks.

Obstetricians traditionally rely on private liability insurance to cover civil compensation. However, private insurance coverage has been insufficient to fully absorb the increasing compensation awarded in recent civil litigation.

To address this issue, the government launched a program to subsidize high-coverage liability insurance premiums for essential medical personnel. Under this program, approximately 75% of the premiums for specialized high-limit liability insurance are subsidized by the state for obstetric specialists and residents of institutions that perform deliveries.

The total insurance premium is 1,700,000 KRW, of which 1,500,000 KRW is paid by the government and 200,000 KRW by the delivery institutions. Under this scheme, maternity hospitals are responsible for compensation amounts up to 200 million KRW, while amounts exceeding this threshold are covered by insurance up to 1.5 billion KRW.

In March 2025, the government announced measures to strengthen judicial protection in essential medical fields in order to establish a medical accident safety environment. The core measures include reducing unnecessary investigations and prosecutions based on essential medical care and gross negligence and expanding the application of nonprosecution agreements to cases of serious injury where consensus is reached between patients and medical staff.

To this end, it plans to establish a ‘Medical Accident Deliberation Committee’ to review whether gross negligence occurred based on medical expertise. The Medical Accident Deliberation Committee comprises members of the medical profession, legal profession, and representatives of patients. It has five specialized subcommittees to review essential medical service eligibility, internal medicine cases, surgical cases, and complex specialized diseases.

The process involves reviewing cases filed with the police or prosecutors before investigations begin. Medical assessments determine whether a case involves essential medical care and assess gross negligence. The committee notified the police or prosecutors of its findings within 150 days. Police and prosecutors respect this decision when deciding whether to prosecute. The criteria for gross negligence are determined at a later stage.

The government expects that operating a Medical Accident Deliberation Committee will reduce indiscriminate criminal complaints and unnecessary socioeconomic costs by completing the determination of essential medical care and gross negligence within 150 days of case submission.

Following the government's announcement of measures, compensation recovery from childbirth accidents is expected to operate in two ways.

If pregnant women and guardians believed that there was no negligence on the part of medical personnel, they would utilize the no-fault compensation system with its increased compensation cap to receive up to 300 million KRW in compensation.

In such cases, medical personnel are expected to participate actively in the no-fault compensation system and accept the results.

If pregnant women and their guardians believe that medical personnel are at fault, they will file a civil lawsuit and await the results. While medical personnel will then be on the opposing side of the lawsuit, if the court-ordered compensation amount is up to 1.7 billion KRW, they can be covered by essential liability insurance, making it highly likely that they will accept the results.

Consequently, 100% of the national financial burden for a no-fault compensation system, an increase in the compensation amount, and national support for liability insurance will contribute to lowering the economic risk of obstetric medical staff. They can also serve as a safety net for patients by providing swift relief from damage.

However, concerns remain. If the indemnity limits of liability insurance fail to reflect inflation and the rising costs of actual medical care and long-term nursing, obstetricians may face an additional burden of amounts exceeding 1.7 billion won. Furthermore, during the system's operation, there is a possibility that some patients or their legal representatives may excessively inflate the claimed damages amount above 1.7 billion KRW, considering the insurance compensation limit. In such cases, the claimed damage amount could be abnormally inflated regardless of the actual scale of damage, potentially leading to the unin tended consequence of increasing compensation amounts accordingly.

Despite the government's efforts, some limitations remain. First, deaths were excluded from the government suggestion. There are many cases where criminal proceedings are filed in which extreme events occur, such as maternal or newborn deaths. In particular, in the case of amniotic fluid embolism or pulmonary embolism, which is a major cause of maternal death, there is no method to predict it with modern medicine, or it is difficult to treat, but the government measures did not include them.

Second, contrary to the government's intentions, the Medical Accident Deliberation Committee could serve as an additional trial. According to the government's measures, prosecution is decided according to the results of deliberation by the Medical Accident Deliberation Committee. Therefore, it is worrisome whether the committee's deliberation process acts as a de facto additional trial process process (pretrial adjudication). If the opinion of the prosecution comes out, the hospital is likely to not accept and actively participate in the lawsuit, which may be a burden to patients and medical personnel who must participate in the trial because of the prolonged period of litigation.

Third, if the scope of gross negligence is widened, contradictions may arise in which the scope of criminal punishment is also widened.

Finally, a further limitation is that the committee includes non-medical personnel, which allows nonexperts to deliberate on highly specialized medical issues.