• The Korea Journal of Herbology
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• v.27 no.2
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• pp.1-16
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• 2012

Objective : To investigate the current status of prescription drugs in Oriental medical institutes and to draw up a future plan for the revitalization of Oriental medical health insurance, this survey has been performed. Method : The survey has been made with 321 doctors working at Oriental medical institutes in Daegu and Kyungbuk areas for a period of 3 month from June 1, 2010 until September 1, 2010. Result : 1. When it comes to the current status of the use of herbal drugs in Oriental Health insurance, most of doctors surveyed prescribe insurance drugs, and they prescribe insurance drugs to patients, who are less than 20% of total patients visiting their clinics. 2. The awareness of Herbal Health Care Drugs is investigated. When it comes to the understanding of the difference between insurance drugs(powder type drugs) and granular type drugs, doctors admit that they differ only in one aspect, whether or not their being covered by health insurance. Based on the survey results on the understanding of insurance coverage of granular type drugs, doctors, even though they long for granular type drugs to be accepted as insurance drugs, are worrying whether the number of outpatients might dwindle due to increased insurance co-payments. They also point out that the biggest obstacles in the expansion of the granular type drugs as insurance drugs are the lack of understanding of the government and the objection of the Health Insurance Review and Assesment service (HIRA) for fear of increased insurance claims. 3. Upon investigation on Oriental medicine doctors' understandings of herbal pharmaceutical industry, it is found that doctors' responses on pharmaceutical industry are not all positive ones('new product development and neglect of R&D infrastructure' and 'smallness of industry'). When it is investigated what area needs the greatest improvement in herbal pharmaceutical industry, 'securing sufficient capital, good manufacturing, and strengthening quality control', is the highest. 4. When it is asked what are the most needed in order to improve herbal health insurance medicine, responses such as 'the increase in the accessibility to and the utilization of Oriental medical clinics through the diversification of the means of prescriptions', 'the improvement of insurance benefits(cap adjustments)', 'increase the proportion of high quality medicinal plants', 'the ceiling of co-payments(deductible) at 20,000 won or more', 'expansion of the choices of formulations', 'formulational expansions of tablets and pills', and finally 'admittance and expansion of granular type drug as insurance drug' are the highest. 5. Upon investigating the general characteristics of the current status of the usage of Oriental health care herbal drugs, the followings are observed. First, the frequency of use of health insurance drugs by the doctors who use health insurance with general characteristics shows similar differences in case of total monthly sales amount (p<0.001), average number of daily patients (p<0.05). Secondly, as to the willingness of the expanded usage of insurance drugs, similar differences are observed in case of total monthly sales amount (p<0.05). 6. Upon investigating the general characteristics of the perception of Herbal health care drugs, the followings are observed. First, inspecting general characteristics and insurance claims due to increased co-payments(deductible amount) reveals similar differences in case of working period (p<0.01) and in case of total monthly sales amount (p <0.01). Secondly, inspecting general characteristics and the obstacles that hinder granular type drugs from being accepted as health care insurance drugs shows similar differences in case of working period (p<0.05). 7. Upon investigating the general characteristics of the understanding of Oriental Herbal pharmaceutical companies, the followings are observed. First, opinions on the general characteristics of pharmaceutical companies, when examined with variance analysis, shows similar differences in case of total monthly sales amount (p<0.05). Secondly, when opinions are examined on general characteristics and the problems of herbal pharmaceutical companies, similar differences are found in case of working period (p<0.01) and in case of total monthly sales amount (p<0.001). Lastly, opinions on the general characteristics and reforms of pharmaceutical companies, similar differences are observed in case of working period (p<0.001). 8. Upon investigating the general characteristics of the improvement of insurance Herbal drugs, the followings are observed. First, regarding general characteristics and insurance benefits, similar differences are observed in case of working period (p<0.05), in case of total monthly sales amount (p<0.05), and in case of average number of daily patients (p<0.01). Secondly, opinions on the general characteristics and the needs for the improvement of Herbal insurance drugs are examined in 5 different aspects, which are the approval of granular type drugs as insurance drugs, the expanded practices of the number of prescription insurance drugs, the needs of a variety of formulations, the needs of TFT of which numbers of Oriental medical doctors are members for the revision of the existing system, and the needs of adjusting the current ceiling of the fixed amount and the fixed rate. When processed by the analysis of variance, the results show similar differences in case of average number of daily patients (p<0.01). Conclusion : From the results of this study the first measures to take are, to reform overall insurance benefit system, including insurance co-payment system(fixed rate cap adjustment), to expand the number of the herbal drugs to be prescribed matching with insurance benefit accordingly, and to revitalize herbal medicine insurance system through the change of various formulations. In addition, it is recommended to improve the effectiveness of herbal medicine by making plans to enhance the efficacy of herbal medicine and by enabling small pharmaceutical companies to outgrow themselves.

• The Journal of the Korean life insurance medical association
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• v.2 no.1
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• pp.245-252
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• 1985

Ultrasonographic examination in the obstetrics not only makes easy of the diagnosis of Hydrocephalus, placenta previa, anencephalus and ectopic pregnancy, etc, but also guaranteed its excellence in the diagnosis of women gynecology disease. Especially in case that it doesn't affect radiation hazard on the embryo, its efficiency keeps increasing and it is spotlighted to many clinic doctors. Even though in general hospital we often observe congenital hydrocephalus in Med. Dept. which entirly undergoes the medical examination to the insured, we don't observe even the women delivered with child and it is very difficult to find a rare congenital hydrocephlus throughout other present insurance companies. We inspected a congenital hydrocephalus, which other medical equipments of present insurance companies have many difficulties in the medical examination, accompanied by meningoencephalocele by ultrasonic diagnosis. We analyzed and compared the data by ultrasonic diagnosis with that of surgical diagnosis and the results are follows; 1) We could correctly describe meningoencephalocele by ultrasonic diagnosis. 2) It was able to be diagnosed in LMP 22 weeks. 3) BPD has about 10 mm higher than normal value in LMP 22 weeks. 4) Dilatation of lateral ventricle was observed in LMP 22 weeks. 5) As paralled with ultrasonic diagnosis in pregnancy medical examination, accepting declines including the risk rate can be restrained.

• Convergence Security Journal
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• v.15 no.6_2
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• pp.79-87
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• 2015

In order to clearly recognize illegality of insurance crime, declaring the provisions on insurance crime is preferable. An insurance fraud differentiated from Configuration Requirements of general fraud should be established And differentiation in accordance with the act type of insurance crime the degree of organizational involvement is required. Also the introduction of civil sanctions and creation of additional punishment provision about Organized insurance fraud are required. To notice duplicate insurance when sign up life insurance, the revision of the provisions is required. To limit unnecessary long-term hospitalization, hospitalization standard is required. Introduction of private investigator is required as a method for endowing with investigation to the staff of insurance companies. By providing information sharing laws between relevant agencies including insurance companies and law enforcement agencies, the foundation of information database, and the introduction of SNA Techniques in the IFAS,, you can detect Organized collusion crime.

• The Journal of Society for e-Business Studies
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• v.19 no.3
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• pp.1-21
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• 2014

Personal information is a requisite for financial transactions as well as a core asset of financial companies. However, as a side effect of the information society, personal information infringements have emerged as significant social risks, causing realized loss to individuals and companies. This study analyzes results of financial and emotional loss in terms of consumer loss and also presents usefulness of insurance in order to minimize such actual damages as a means of risk transfer. In addition, this study investigates components and premium calculation principles of compensation insurance against personal information invasion and finally presents policies to activate these insurance product. As a method of risk management, insurance not only is a useful tool to guarantee consumer protection and companies' financial soundness simultaneously but also provides a basis of quantitative measurement of IT risks.

• Asia-Pacific Journal of Business
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• v.3 no.1
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• pp.39-47
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• 2012

Organizations pursue a CRM strategy for the purpose of increasing business performance and value. However, firms face a multitude of organizational challenges associated with this endeavor. To reduce their risk of failure, it is suggested that firms undertake a deep analysis of organizational readiness prior to committing to a CRM initiative. Insurance sector is no exception to this fact. There is an increased need to concentrate on the various challenges thrown open by the public insurance firms in implementing CRM. Many insurance firms have invested into customer driven CRM but research indicates varying outcomes (Schmith 2004). While it is clear that there are significant issues involved in the CRM implementation and success and environment faced by the public sector. It is clear that business should have an easier time in applying CRM systems is the strategic value for public sector. With customers demanding more service and accessibility from administrators, public sector CRM software technologies have to offer best solutions for achieving process and cost objectives (Souder 2001). With results which go far beyond improved service delivery and include sustained cost reductions, increased customer knowledge and better employee morale, CRM software implementation and post product environments offer great upside value. Although there are material differences in public sector use of CRM strategy, they share at least one glaring similarity - they have much to gain from proven CRM software technology. As business methods cross over in the public sector, many government bodies are investigating how they can adopt and adapt various CRM models (Bleyer 2003). There is a need to understand the similarities and differences in public sector CRM to foster shared knowledge, business processes and planning functions to integrate disparate technologies and software platforms and then, of course, the organizational culture to support knowledge sharing (Peters 1997). For the public sector, there are clearly identified CRM processes which have resulted in increased profits and improved efficiency. These have focused on sales, marketing and customer service activities, which often operate along fundamentally different lines in various public sector insurance companies. Thus the present research paper makes an attempt to explore how public sector CRM methods can be adopted and subsequently adapted.

• Proceedings of the Korea Inteligent Information System Society Conference
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• 2000.04a
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• pp.365-373
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• 2000

Data Envelopment Analysis (DEA), a non-parametric productivity analysis tool, has become an accepted approach for assessing efficiency in a wide range of fields. Despite of its extensive applications and merits, some features of DEA remain bothersome. DEA offers no guideline about to which direction relatively inefficient DMUs improve since a reference set of an inefficient DMU, several efficient DMUs, hardly provides a stepwise path for improving the efficiency of the inefficient DMU.In this paper, we aim to show that DEA can be used to evaluate the efficiency of life insurance companies while overcoming its limitation with the aids of machine learning methods.

• The Journal of Information Systems
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• v.22 no.1
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• pp.181-200
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• 2013

Electronic channel of automobile insurance has emerged as an attractive way of lowering costs and saving time to do the transaction for customers. Electronic channel refers to using web sites to find useful information on insurance products, buy automobile insurance, and ask for services related to the insurance. This study suggests a modified model of the UTAUT and examines the factors influencing intention to use electronic channel in the transaction of automobile insurance. Based on 203 responses from potential automobile insurance buyers, the results showed that performance expectancy, effort expectancy, social influence, service expectancy, and security risk are significantly related to intention to use electronic channel. The results also showed that age as a moderator influences the effects of performance expectancy and effort expectancy on intention to use electronic channel. The study results would improve the understanding of the factors to which managers of insurance companies should pay attention in order to increase their sales through electronic channel.

• Journal of the Korea Society of Computer and Information
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• v.24 no.1
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• pp.207-215
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• 2019

The insurance system is indispensable to our society. However in recent years, there have been a lot of insurance fraud crimes, such as the abuse of these valuable insurance system and the cheating the insurance proceeds. These insurance frauds make the insurance companies harder to manage, and as a result, the insurance premiums have risen, which has caused a lot of damaging good policyholders. However, the damage caused by insurance fraud has been continuously increasing due to the punishment of cotton stick. Therefore, after the long discussion, the 'The Act for Prevention of Insurance Fraud', which is a special law recently has been enacted. However, within two years of the enactment of this law, which was enacted after much anticipation and long waiting, there is already debate about its effectiveness. The reason for this is that even though the law was enacted and enforced, insurance fraud continues to increase and even punishment for these crimes is not strengthened, and now it is time to look for specific problems and resolutions for these crimes see. So in this paper the author dealt with the problems of the law, first, related regulation of insurance payment, second, right to terminate insurance contract and return of insurance proceeds, third, regulation on notification of investigations, fourth, regulations on the adequacy of hospitalization. Of course, since this law has just been enacted, there are many other problems besides these problems, but I tried to present a fresh resolution based on the problems that have been mainly discussed since the legislative period.

• East Asian mathematical journal
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• v.38 no.5
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• pp.617-641
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• 2022

In this study, we first present a brief overview of the Korean general insurance market. We then explore the characteristics of the loss ratios of the Korean general insurance industry and apply Markov regime-switching methodology to model the loss ratios of these insurance companies by line of business based on changes in economic regimes. This study applies a number of confirmatory tests such as Zivot-Andrews test (2002), the Chow (1960) test and the Bai and Perron (1998) to confirm the presence of structural breaks in the time series of the loss ratios by line of business. Then, we employ Markov regime-switching methodology to model these loss ratios. We find empirical evidence that the loss ratios reported by insurance companies in Korea is characterized by two distinct regimes; a regime with high volatility and a regime with low volatility, except for vehicle insurance. Our analyses suggest that macro-economic conditions have significant explanatory effect on loss ratios but the direction of effect differs based on the line of business and the regime. Unlike previous studies that have applied linear regressions or divided the samples into different periods and then apply linear regressions to model loss ratios, we argue for the application of Markov regime-switching methodology, which are able to automatically distinguish the different regimes that may be associated with the movements of loss ratios based on differing economic conditions and regulatory upheavals. This study provides a more in depth understanding of loss ratios in the general insurance industry and will be of value to insurance practitioners in modelling the loss ratios associated with their businesses to aid in their decision making. The results may also provide a basis for further studies in other markets apart from Korea as well as for shaping policy decisions related to loss ratios.

• Korean Security Journal
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• no.32
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• pp.151-176
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• 2012

Government organizations (including police, prosecutor, and Financial Supervisory Service) and programs to uncover or prevent from insurance crime are not well developed. However, insurance crime are increasing among not only private insurances such as life insurance, indemnity insurance, and auto insurance but also public insurances including national health insurance and industrial accident compensation insurance. The damages of crimes are serious in both economical and ethical perspectives. Insurance crime deteriorates a current account of insurance companies and the leakages due to insurance fraud worsen loss ratio. Consequently, insurance crime increases customers' costs of insurance. For this reason, insurance companies stated to establish Special Investigation Unit(SIU) to detect insurance crime and fraud by themselves. However, organizational and operational efficiencies are limited. The purpose of this study is to examine the relationship between work environment factors, perception of insurance crime and job satisfaction among Special Investigation Units. Therefore, this study investigated the perception of work environments of Special Investigation Units. In addition, this study examined how their work environments and general perception of insurance crime influence their job satisfaction. In order test the purpose of this study, reliability test, exploratory factor analysis(EFA), multiple regression were employed. The results of this study suggested that clarity of insurance company, distress/difficulty of resolve, compensation, perception of work pressure are statistically significant on jab satisfaction among Special Investigation Unit in South Korea. This exploratory study expected to contribute to understanding of Special Investigation Unit, and their insurance crime prevention system. The results from this analysis will be examined in light of previous findings and policy implications discussed.