Kyusung Lee Attorney at Law

Steroid Side Effect → Avascular Necrosis → Hip Replacement → Insurance Dispute Victory

Attorney Kyusung Lee | Medical Litigation & Insurance Dispute Specialist

My client was prescribed steroid medication by a hospital doctor. As a direct result, the bones in both hips began to die — a condition known as avascular necrosis. She ultimately required total hip replacement surgery. She had an accident insurance policy and filed a claim. The insurer’s response? A lawsuit declaring it owed nothing.

Their argument: “This is a disease, not an accident. Your policy doesn’t cover it.”

This is not a hypothetical. It happens. And it is a fight you cannot win alone.

This post describes how Attorney Kyusung Lee secured a complete victory — the insurer’s claim dismissed, the client’s counterclaim fully upheld.

Case Overview — What Happened?

The Client’s Story

In January 2019, the client sought medical treatment for a vision problem diagnosed as vertical strabismus (superior oblique myositis). The treating physician prescribed Solondo, a corticosteroid medication, for approximately two months at a total dose of 2,270 mg.

About one year later, in February 2020, the client began experiencing sudden, severe hip pain. The diagnosis was devastating:

“Bilateral avascular necrosis of the femoral head” — a condition in which blood supply to the bone is cut off, causing the bone tissue to die.

On February 17, 2020, the client underwent total hip replacement surgery on the right side.

The Insurer’s Surprising Response

The client had maintained an accident insurance policy with Heungkuk Fire & Marine Insurance since 2012. In April 2023, she filed a claim for permanent disability benefits.

The insurer refused to pay. It then took the offensive: it filed suit against the client seeking a court declaration that it owed no benefits whatsoever — a so-called “non-existence of debt” action.

The insurer’s theory:

• “A steroid side effect is not a ‘sudden, fortuitous, external accident’”
• “Therefore it does not qualify as an ‘accident’ covered under the policy”

Why This Case Is Difficult — What Non-Specialists Cannot Handle

① Insurance Policy Interpretation — The Legal Definition of “Accident”

Under Korean accident insurance policies, an “accident” is defined as “a sudden, fortuitous, and external incident” causing bodily harm. These three elements — suddenness, fortuitousness, and external origin — may sound simple, but decades of Korean Supreme Court precedent apply them in highly nuanced ways. When medical treatment is involved, insurers routinely claim the condition is a “disease” rather than an “accident.”

We constructed our counter-argument using the following precedents:

• External origin: It is sufficient that the cause is an external factor, not the policyholder’s constitutional predisposition. (Supreme Court 2010Da12241)
• Fortuitousness: The injury must arise from a cause the policyholder could not have foreseen and must not be intentional. (Supreme Court 2008Da78491)
• Suddenness: Includes results that materialize at an unpredictable moment, not only instantaneous events. (Busan High Court 98Na130)

Steroids are an externally administered substance — satisfying the external origin requirement. Not everyone who takes steroids develops avascular necrosis — satisfying fortuitousness. The client could not have predicted that she would need a hip replacement — satisfying suddenness.

② Medical Complexity — The Critical Role of Expert Medical Review

The insurer argued: “The avascular necrosis may have been caused by alcohol consumption and smoking, not the steroids.” The client’s prior medical records did contain references to alcohol use. The insurer made this its centerpiece.

To address this, we requested that the court commission a formal medical record review by the Department of Orthopedic Surgery at Daegu Catholic University Medical Center. The reviewing expert’s opinion was decisive:

“The patient received a high dose of steroids over a short period, and steroid use is most likely the primary cause of the avascular necrosis of the femoral head.”

We also successfully challenged the credibility of the opinion submitted by the treating physician. We pointed out to the court that the same physician who prescribed the steroids was potentially exposed to medical malpractice liability — creating a clear conflict of interest that the court ultimately accepted.

③ Rebutting the Alcohol/Smoking Attack

The insurer combed through the client’s prior medical records and found an entry for “alcoholic hepatitis,” arguing this proved alcohol caused the necrosis. In fact, that diagnosis code had been entered temporarily because no other code was available at the time, and it was subsequently corrected.

We neutralized this attack entirely through careful analysis of the original medical records and physician statements.

The Verdict — Complete Victory

Suwon District Court, March 19, 2026, Case Nos. 2024GaDan520684 (Insurer’s Claim) / 2024GaDan534843 (Client’s Counterclaim)

Item	Outcome
Insurer’s Claim (Non-Existence of Debt)	Dismissed
Client’s Counterclaim	Fully Upheld
Insurance Benefits Awarded	KRW 15,000,000
Delay Interest Commencing	May 2, 2023
Legal Costs	Borne entirely by the insurer

The court recognized the incident as an “accident” on five grounds:

• ① Fortuitousness — avascular necrosis is not a universal side effect of steroids
• ② External origin — steroids are an external cause
• ③ Rejection of the treating physician’s opinion — court-commissioned expert more objective than a physician with potential malpractice exposure
• ④ Inadequate warning — no evidence that the hospital specifically advised the client of avascular necrosis risk
• ⑤ Suddenness — steroid effects accumulated and manifested at an unpredictable moment

Why Legal Representation Was Decisive

First: Designing the Medical Record Review Request

It is not enough to simply “ask for an expert review.” Which hospital, which questions, and which documents are submitted all determine the outcome. We proactively incorporated the alcohol and smoking issues into the scope of the review, steering the expert’s opinion in our favor.

Second: Challenging the Credibility of the Treating Physician

The treating physician’s opinion carries apparent medical authority. But we identified the conflict of interest — the prescribing physician could face malpractice liability — and persuaded the court to disregard that opinion accordingly.

Third: Precision Legal Argumentation on Policy Terms

Applying the three elements of suddenness, fortuitousness, and external origin to the specific facts of a case is a different skill from simply knowing the legal definitions. It requires analysis of dozens of analogous precedents and the construction of arguments tailored to the precise circumstances.

Is This Your Situation? Check These Criteria

If any of the following applies to you, please consult a qualified attorney immediately:

• ✅ You developed avascular necrosis of the femoral head after taking steroid medication
• ✅ You were denied insurance benefits after hip or knee replacement surgery
• ✅ Your insurer has filed a lawsuit against you seeking a declaration that it owes no benefits
• ✅ Your insurer argues that your injury is a “disease” and not an “accident”
• ✅ You are in a dispute involving bodily injury caused by medical treatment (injections, procedures, medication)

Why This Type of Case Requires a Specialist

Cases combining medical litigation and insurance disputes require all of the following:

• Expertise in insurance policy interpretation and accident/disease case law
• Ability to analyze medical records and assess medical causation
• Strategy for commissioning and leveraging expert medical reviews
• Skill in challenging the credibility of opposing medical opinions

Few attorneys possess all of these capabilities. Attorney Kyusung Lee has built deep experience in this field through actual litigated victories.

Closing Thoughts

Insurance companies have specialized legal teams and extensive litigation experience. Facing them alone puts you at a serious disadvantage.

But with the right legal framework and carefully constructed medical evidence, you can win. This case proves it.

If you are dealing with a steroid side effect, a medical incident, or an insurance dispute over injury benefits, please do not hesitate to contact Attorney Kyusung Lee.

Tel: +82-2-6264-7604  |  kyusungii@gmail.com  |  http://www.kyusunglee.com

Attorney Kyusung Lee  |  Medical Litigation · Insurance Disputes · Bodily Injury Claims

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