SEOUL, Jan. 15 (Korea Bizwire) — South Korea’s National Health Insurance Service suffered another legal setback Thursday in its long-running effort to hold tobacco companies financially responsible for smoking-related diseases, as an appeals court again rejected its claim for damages—12 years after the lawsuit was first filed.
The Seoul High Court upheld a lower-court ruling dismissing the case brought by the National Health Insurance Service against major cigarette makers KT&G, Philip Morris Korea and BAT Korea. The insurer had sought 53.3 billion won ($40 million) in compensation for additional medical costs it said were caused by smoking-related cancers.
The lawsuit, filed in April 2014, targeted treatment expenses paid on behalf of 3,465 patients who had smoked the equivalent of at least one pack a day for 20 years or more and were later diagnosed with lung or laryngeal cancer. The central legal question was whether a direct causal link could be established between smoking and each individual patient’s illness.
The court concluded that while epidemiological studies show a strong statistical association between smoking and lung cancer, such data alone are insufficient to prove causation in individual cases.
It also ruled that the health insurer failed to demonstrate that the tobacco companies had committed an unlawful act through defective product design or inadequate health warnings—an essential prerequisite for awarding damages.
Citing Supreme Court precedent, the judges said that proving someone smoked and later developed cancer does not automatically establish legal causation. Factors such as the timing and duration of smoking, preexisting health conditions, lifestyle habits and family medical history must also be weighed.
What’s inside a cigarette? Korea to make the List public (Image courtesy of Yonhap)
The court rejected the insurer’s argument that the burden of proof should be shifted to the tobacco companies, distinguishing cigarette manufacturing from pollution cases in which such evidentiary relief is sometimes granted.
The panel also dismissed claims that cigarette makers were legally obligated to reduce nicotine levels to non-addictive thresholds or that design features such as ventilated filters made cigarettes more harmful.
It said scientific evidence on additives and design choices remained inconclusive and that the addictive and harmful nature of smoking is already widely recognized by the public.
Because the court found no illegal conduct by the defendants, it declined to rule further on individual causation. It also rejected the insurer’s attempt to recover costs by asserting patients’ claims on their behalf, finding that insurance payouts stemmed from the statutory health insurance relationship rather than wrongdoing by the tobacco companies.
A lower court had reached the same conclusion in 2020, and Thursday’s ruling effectively confirms that outcome. Despite the loss, the court acknowledged the extensive effort involved in reviewing thousands of medical records and research submissions, noting that public attitudes toward smoking continue to evolve.
Jung Ki-seok, president of the National Health Insurance Service, said the ruling was “disappointing” but added that recognition of tobacco-related liability could still come in the future, as social awareness and policy standards change.
Jerry M. Kim (jerry_kim@koreabizwire.com)
