• Title/Summary/Keyword: Compulsory Insurance

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About Insurance Benefits Restriction Condition of National Health Insurance Act Article 48 Paragraph 1: 'When He has Through Gross Negligence Caused a Criminal Conduct' (국민건강보험법 제48조 제1항 제1호 보험급여 제한 요건 '중과실에 의한 범죄행위로 기인한'에 대한 소고)

  • Jung, Oh-Kyun
    • The Korean Society of Law and Medicine
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    • v.13 no.1
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    • pp.11-40
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    • 2012
  • National Health Insurance Act has been enforced all over the People as part of the effort to assure the minimum constitutional human worth and dignity in the aspect of the right to pursue health for preventing misfortune that comes to death without even a chance to be received treatment for illness or injury. Meanwhile auto insurance is compulsory in certain parts in order to promote benefits of everyday life and the rapid recovery of the damage caused by traffic accident when one have negligently driven a car which has become the necessities in daily life. Any injured driver in a traffic accident can be treated by National Health Insurance without getting an auto insurance in various circumstances, but Article 3 paragraph 2 of Traffic Accident Act don't allow exception of criminal punishment when he has driven a car without license, drunken, or tresspassing the centerline, etc. When the injury occured by his own certain negligence is judged to 'when he has intentionally or through gross negligence caused a criminal conduct or intentionally contributed to the occurrence of an accident' of National Health Insurance Act, insurance benefits can be restricted. Such a restriction could harm the right to pursue happiness and health of People by depriving the poor, who cannot afford to pay, of chances to get treatment. Here we will see benefit restriction by 'gross negligence' of National Health Insurance Act Article 48 paragraph 1, which has largest portion of such restriction. It is desirable to delete 'gross negligence' clause from above paragraph and to interpret 'when' clause restrictively for diminishing confusion of interpreting and guaranteeing the right of health.

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A study on mandatory insurance for aircraft operators (항공보험 가입의무에 관한 연구)

  • Lee, Chang-Jae
    • The Korean Journal of Air & Space Law and Policy
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    • v.33 no.2
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    • pp.169-197
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    • 2018
  • The purpose of this study is to present a reasonable and concrete standard for the Korean aviation insurance compulsory subscription system. Through this, we aim to improve the current revision of laws and regulations, and ultimately create an environment in which the safety and property of the Korean people who use aircraft with appropriate aviation insurance can be secured. In particular, by reviewing the aviation business law and its new laws and regulations enacted in 2017, the legislative improvement direction of aviation insurance will be proposed. In order to maintain the continuous growth of the air transportation industry and to make amicable compensation for the victims, considering the characteristics of the total accident, instantness, and giganticness of air accidents in which a lot of people and property are lost in the event of an accident, adequate insurance coverage is essential. In this respect, the compulsory insurance to amend the principle of freedom of contract, which is the great principle of the modern judicial system, will be persuasive. However, in comparison with foreign legislation, the legal provisions on Korea's obligation to comply with aviation insurance need to be revised around the following issues: First, it is reasonable to enforce the regulation of the mandatory aviation insurance by legislation from the Congress not by administrative regulations. Because it will force the monetary obligations of the individual such as common air carriers. Second, our law regulations respond to various kinds of air damages by using the phrase "limit of liability stipulated in international conventions". However, as we have seen in the text, the range of compensation are various according to the use of legal instruments in international conventions such as the Montreal Convention, which governs the compensation of passengers for damages to passengers today. Third, in countries with narrow territories, such as Korea, there are big differences in flying time and insurable risk between domestic and international transportation. Therefore, it is necessary to divide domestic transportation and international transportation even in the obligation to join the insurance. This dual discipline has the advantage for rookies in air carrier market who mainly start their business from domestic service. Fourth, according to Korean law, the regulations of automobile loss insurance is applicable to the aviation mandatory insurance of unmanned aerial vehicle accident which is lack of persuasion. In the future, it will be appropriate to discipline insurance for unmanned aerial vehicles with unlimited potential for development from a long-term perspective.

Coverage Method in German Workers' Compensation Insurance and Policy Implications: Focusing on Volunteers and Persons in Special Types of Employment (독일 산재보험제도의 적용방식과 시사점: 자원봉사자와 특수형태근로종사자 중심으로)

  • Kim, Sang Ho
    • 한국사회정책
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    • v.20 no.3
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    • pp.171-195
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    • 2013
  • One of the current issues in Workers' Compensation Insurance is about the coverage range. Korea uses the definition of worker under the Labor Standards Act in Workers' Compensation Act and solved the problems associated with the coverage range of insurance group by the exceptional clause only for the groups which was raised about the need for the social protection. The purpose of this paper is to draw implications for solving problems which are associated with the coverage range of insurance group by reviewing the German literature. We focus on volunteers and persons in special types of employment. German government supports the activity of volunteers by providing with the protection service against the accidents. This paper shows how the coverage range is extended from the dependent employees in the introduction of the Workers' Compensation Insurance to the people who need social protection focusing on the volunteers. The implications of this research are following. First, German system shows that Workers' Compensation Insurance can be extended to the groups which do not belong to the dependent employee but are worthy of protection. Second, it is necessary to provide volunteers in the social welfare system with the protection service against the accidents and the statutory accident scheme is recommendable to use. Third, volunteers in the social welfare system need to be compulsory insured. Fourth, Korea should find their own way in solving problems associated with persons in special types of employment.

Analysis on the safety perception of ocean leisure business owners (수상레저 사업자의 안전의식 실태 분석)

  • Jeong, Jong-Seok
    • Journal of Navigation and Port Research
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    • v.32 no.5
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    • pp.409-413
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    • 2008
  • This study came to the following conclusions through the survey which was conducted to ocean leisure business runners to find out current business situation and the perceptions about the revised regulations the safety law of water leisure. This survey showed that most of the respondents agreed about receiving water safety training for regulated time when they obtain or renew their licenses. 63.5% answered that water safety training is needed. There was a considerable demand for registration system of leisure boots. 70.3% presented that registration system of private leisure boots should be introduced. It is confirmed that insurance is an essential fact for ocean leisure activities. 81.1% for leisure boots and 70.3% for non-leisure boots respectively answered that private insurance or fraternal insurance need to be imposed as a compulsory condition in case of accidents during ocean leisure activities.

Impact of the Purchasing Price Reimbursement System for Insurance Drugs upon the Health Insurer's Financial Situation (실거래가상환제의 건강보험재정에 대한 영향)

  • Jeong, Hyoung-Sun;Lee, Eui Kyung;Kim, Eun Jung;Ryu, Gun-Chun;Song, Yang Min;Kim, Sun-Ju
    • Health Policy and Management
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    • v.15 no.3
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    • pp.40-59
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    • 2005
  • The objective of this paper is to examine what impact the newly introduced Purchasing Price Reimbursement System, where insurance drugs are reimbursed at the prices as they were purchased by medical care providers under the maximum allowable cap, has upon the health insurer's financing situation. The impact of the Purchasing Price Reimbursement System is considered to be confined mainly to the inpatient department among three drug reimbursement fields such as inpatient department, out-patient department and pharmacy. Hypothesis was set and tested in this study for each of three components of inpatient drug reimbursement in health insurance, i.e. average price level, composition of drugs and their overall volume. Drug price level calculated in this study from 403 selected reimbursement drugs according to the Laspayres methodology revealed faster decline under the new Purchasing Price Reimbursement System than previously by $1.53\%$ on the annual average basis. However, additional 1.4 percent financial burden in the ratio of the total inpatient reimbursement was owed by the health insurer. This was analysed to be a combined result of both 2.0-3.1 percent of reduced reimbursement due to drug price decline and 3.4-4.5 percent of additional reimbursement due to drug volume increase. These results suggest that recalling the Purchasing Price Reimbursement System would not have so much impact upon the health insurer's financial situation given that the current compulsory separation between doctor's prescribing and pharmacist's dispensing is irrevocable.

Anti-Fraud in International Supply Chain Finance: Focusing on Moneual Case

  • Han, Ki-Moon;Park, Sae-Woon;Lee, Sunhae
    • Journal of Korea Trade
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    • v.24 no.1
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    • pp.59-81
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    • 2020
  • Purpose - This study analyzes the scope of due diligence and risks of banks and K-Sure in trade finance covered by EFF focusing on Moneual case, one of the latest and biggest trade finance fraud cases in Korea. Also, we suggest anti-fraud measures in trade finance on the part of banks and K-Sure in order to give them a desirable way of due diligence and reasonable risk management of export insurance. Design/methodology - Based on Moneual case of trade finance fraud, this study employs the methodology of an extended literature review and analysis of court decisions. Findings - Seoul High Court of Korea failed to decide whether K-Sure was wholly obliged to pay the insurance against the banks' EFF claims, but issued a compulsory mediation order, judging that both the banks and K-Sure were responsible by 50:50. The court may have judged that both the parties had lacked their due diligence in the trade finance. It is quite difficult for trade finance providers to manually investigate whether the transaction is suspected of trade finance fraud, so digitalization of trade finance which can facilitate the prevention and detection of trade fraud needs to be realized quickly. Since there has been no international rule available for open account trade finance up till now, clearly stipulated EFF terms on the exporter's genuine export obligation might have protected K-Sure from the disaster. Originality/value - This study investigates the due diligence of the banks and K-Sure in Moneual case which few researchers have considered, to the best of our knowledge. This study also suggests several practical methods (including block chain) to prevent complicating trade finance fraud amid increasing use of an open account, and further offers reasonable risk management of EFF employing international factoring rule which is also related to problematic open account trade finance.

A Cargo Insurer's Right of Direct Action against P&I Club - Focused on Docket No.2012 gadan 503694 in Seoul Central District Court- (선주상호보험조합에 대한 적하보험자의 직접청구권 -서울중앙지방법원 2012가단503694 판결을 중심으로-)

  • Lee, Wonjeong
    • Journal of Korea Port Economic Association
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    • v.30 no.4
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    • pp.111-130
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    • 2014
  • The article 742(2) of the Korean Commercial Code allowed the third party to invoke a direct action against the insurer under a liability insurance. Meanwhile, the owners of the vessel enter into the P&I Insurance Contract with the P&I Club to indemnify all kinds of liability or expenses involved in the operation of its vessel. However, the Rule Book under the P&I Insurance mostly included the Pay to be Paid Clause which precludes the third party's direct action. Recently, the Seoul Central District Court passed a judgement on the validity of the Pay to be Paid Clause under the Korean law against the third party i.e. the cargo insurer having the right of subrogation. The court held that (1) the third party's right of direct action is not the right to claim insurance money but the right to claim damages against the P&I Club, (2) the insurer under a liability insurance is deemed to assume liability jointly and severally with the insured against the third party, (3) the Article 742(2) of the Korean Commercial Code is considered as a compulsory provision because it was invented to protect the innocent third party, the Paid to be Paid Clause is thus null and void. The purpose of this article is to evaluate the appropriateness of this court's judgments by comparative analysis of Korean and English law, and to suggest the relevant amendments of the Korean Commercial Code in order to prevent further legal disputes. The article criticizes the decision of the Seoul Central District Court, taking the attitude that, since the third party's right is the right to claim insurance money, the Paid to be Paid Clause is valid against the third party.

A Study on the Effect of Benefit Limit Measure on the likelihood of the late payers of paying missed health insurance premium: The Case of Korea (건강보험료 체납자에 대한 급여제한 사전통지제도의 효과성 분석)

  • Cho, Byong-Hee;Yoo, Taekyun;Yun, Seong-Won
    • Korean Journal of Social Welfare Studies
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    • v.44 no.3
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    • pp.421-450
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    • 2013
  • One of the challenging tasks of the National Health Insurance Corporation(NHIC). the only public insurance institution administrating the Korea's compulsory national health insurance(NHI) system, is to make those NHI beneficiaries who fail to make a scheduled monthly premium payment to pay. For this purpose, the NHIC has been using a measure known as 'Benefit Limit Measure(BLM)' in which those who miss premium payment for six or more month's in total are classified as 'late payer' and are sent warnings and late payer status notices. If the late payers fail to make a full payment of missed premiums even after receiving the written notices, the NHIC can order a temporary seizure of the late payer's property until all missed premiums plus interest are paid. Recently, the BLM has been criticized by the public of its cruel nature, and its effectiveness has been questioned because no empirical evidence has been collected. In this study, the authors using the NHIC data set attempted to analyze the effectiveness of the BLM. Those late payers for whom the BLM was administered were compared to those not in terms of the likelihood of paying missed premium payments with a series of logistic regression analyses models. Data analyses results showed that the likelihood of paying one or more month's unpaid premium of the former group was 14 to 46 times higher than the latter. It, however, was also found that the BLM was only effective to make no more than 12% of the late payers to pay at all. Based on the study findings, the authors made a few recommendations regarding the BLM.

1970-2014 Current Health Expenditures and National Health Accounts in Korea: Application of SHA2011 (1970-2014년 경상의료비 및 국민보건계정: SHA2011의 적용)

  • Jeong, Hyoung-Sun;Shin, Jeong-Woo
    • Health Policy and Management
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    • v.26 no.2
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    • pp.95-106
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    • 2016
  • A new manual of System of Health Accounts (SHA) 2011, was published jointly by the Organization for Economic Cooperation and Development (OECD), Eurostat, and World Health Organization in 2011. This offers more complete coverage than the previous version, SHA 1.0, within the functional classification in areas such as prevention and a precise approach for tracking financing in the health care sector using the new classification of financing schemes. This paper aims to demonstrate current health expenditure (CHE) and National Health Accounts of the years 1970-2014 constructed according to the SHA2011. Data sources for public financing include budget and settlement documents of the government, various statistics from the National Health Insurance, and others. In the case of private financing, an estimation of total revenue by provider groups is made from the Economic Census data and the household income and expenditure survey, Korean healthcare panel study, etc. are used to allocate those totals into functional classifications. CHE was 105 trillion won in 2014, which accounts for 7.1% of Korea's gross domestic product. It was a big increase of 7.7 trillion won, 7.9%, from the previous year. Public share (government and compulsory schemes) accounting for 56.5% of the CHE in 2014 was still much lower than the OECD average of about 73%. With these estimates, it is possible to compare health expenditures of Korea and other countries better. Awareness and appreciation of the need and gains from applying SHA2011 for the health expenditure classification are expected to increase as OECD health expenditure figures get more frequently quoted among health policy makers.

Comparison of Regulatory Systems for Safety and Health Management in Research Laboratories - Case Review between Korea and Germany (연구 실험실 안전보건 관리제도 비교 - 한국과 독일 사례 고찰)

  • Park, Jihoon;Sung, Baeckkyoung;Altmeyer, Matthias Oliver;Kim, Young Jun
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.30 no.2
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    • pp.99-108
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    • 2020
  • Objectives: This study aimed to compare the regulatory systems for laboratory safety and health management between Korea and Germany and discuss the implications. Methods: Laboratory safety and health regulations for legal enforcement and relevant technical guidelines in Korea and Germany were reviewed. Results: Lab safety and health management is enforced by the Act on the Establishment of Safe Laboratory Environment in Korea. Most provisions focus on supervisory control, that is, the principal's liability is emphasized. In addition, there is a lack of laboratory-specific procedures for safety and health management in the act since it is stipulated that other relevant regulations apply to some technical contents. Non-compulsory technical guidelines for lab safety and health management are also provided by the Korea Occupational Safety and Health Agency (KOSHA) in order to enable researchers to follow safe procedures. There is no independent regulation for lab safety and health in Germany, and it is also governed by several regulations. The German Social Accident Insurance Institute provides technical guidelines on lab safety and health, and these contain more specific content to allow them to be followed more easily compared to the KOSHA guidelines. The most remarkable differences between the regulation of each country were contents of the risk assessment and specific protect measures from hazardous agents. Conclusions: Regulatory control is an essential way to prevent accidents, but it is more important to create an environment in which all stakeholders, including individual lab members, are allowed to participate actively in safety and health management activities.