• Title/Summary/Keyword: Insurance Contract

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Review of 2022 Major Medicla Decisions (2022년 주요 의료판결 분석)

  • Lee Jeongmin;Yoo Hyunjung;Park Taeshin;Jeong Heyseung;Cho Woosun;Park Nohmin
    • The Korean Society of Law and Medicine
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    • v.24 no.2
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    • pp.79-117
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    • 2023
  • Among the healthcare-related judgments handed down in 2002, there was a significant ruling on the timing of the duty of explanation, stating that, in order to ensure the exercise of the patient's right to self-determination, the patient must be given time to consider and decide on the risks and side effects of a medical procedure in specific circumstances. In addition, in a case where an insurance company claimed unjust enrichment against a medical institution on behalf of its insureds, the court provided a clear standard by distinguishing between active and passive requirements regarding the need to preserve the right of subrogation of creditors. In the area of medical administration, there was a ruling that clarified that a medical institution's business suspension under the National Health Insurance Act is directed against the medical institution, a ruling that broadly recognized causation in a case of compensation for side effects of corona vaccination, and a ruling on the scope of a medical practitioner's license, such as the use of ultrasound devices by an oriental medicine practitioner. In a case involving a patient's claim for eviction from a medical institution, the court reviewed a ruling on just cause for termination of a hospitalization contract in relation to Article 15(1) of the Medical law.

A Study about the Legal Nature of Negotiations between NHIS and Pharmaceutical Company (국민건강보험공단과 제약사 간 의약품 관련 협상 행위의 법적 성격에 관한 고찰)

  • DUCKGYU JANG
    • The Korean Society of Law and Medicine
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    • v.23 no.4
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    • pp.3-28
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    • 2022
  • Recently, the targets and clauses of negotiation between 'National Health Insurance Service (NHIS)' and Pharmaceutical companies has been expanded. Due to newly adopted 'Quality management clause', 'Compulsory supply maintenance clause' and 'Penalty for breach of contract clause', not only 'Ministry of Health and Wellfare (MOHW)'s 'drug listing' and 'Price cap' announcement, but also 'negotiation between NHIS and pharmaceutical companies' can be a legal sanction to the suppliers. Once secretary of MOHW order NHIS to negotiate with pharmaceutical company, NHIS notify this order to the company and enter into the negotiation. 'The order' exists in the public domain between the government (MOHW) and public institutions (NHIS) and does not constrain the legal rights of companies (Therefore companies cannot pile a lawsuit about the order). However, 'the notice' or 'negotiation' is an act which has a counterpart, can be a target of administrative litigation if the company get some disadvantages from the talks. Negotiations can be divided into four types according to "the target (whether it is listed on the insurance benefit list)" and "the purpose (whether the target is price or conditional)." In particular, negotiations on listed drugs, whose goal is to set unfavorable conditions for companies, can be illegal if there is no price. So we need to consider compensation for the company as an incentive to negotiate.

A Study on the Maritime Law According to the Occurrence of Marine Accidents of MASS(Maritime Autonomous Surface Ship) (자율운항선박의 해양사고 발생에 따른 해상법적 고찰)

  • Lee, Young-Ju
    • Maritime Security
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    • v.6 no.1
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    • pp.37-56
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    • 2023
  • Recently, with the rapid development of ICT(Information and Communication Technology) and AI(Artificial Intelligence) technology industries, the emergence of MASS(Maritime Autonomous Surface Ship), which were thought only in the distant future, is approaching a reality. Along with the development of these amazing technologies, changes in the private law sector, such as liability, compensation for damages, and maritime insurance, as well as in the public law sector, such as maritime safety, marine environment protection, and maintenance of maritime order, have become necessary in the field of maritime law. In particular, with the advent of a new type of ship called MASS that does not have a crew on board, the kind and type of liability, compensation for damages, and insurance contracts in the event of a marine accident will also change. In this paper, the general theory about concept, classification, effectiveness and future of MASS and the general theory about concept and various obligations and responsibilities under the maritime law for discussion of MASS are reviewed. Next, in addition, regarding the problems that may occur in the event of a marine accident from MASS, the status as a ship, the legal relationship of the chartering contract, obligation to exercise due diligence in making the vessel seaworthiness, subject of responsibility, and liability for damages and immunity are reviewed from the perspective of maritime law. In addition, in the degree four of MASS, the necessities of further research to clarify the attributable subjects and standards of responsibility in the event of a marine accident, as well as the necessities of institutional improvement such as technology development, enactment and amendment of law and funding are presented.

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A Study on the Procedure Model to Carry on Works of the Private Security Company (민간경비업체의 업무 수행 절차 및 모델 설정에 관한 연구)

  • Lee, Sang-Chul;Kim, Tae-Min
    • Korean Security Journal
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    • no.6
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    • pp.47-65
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    • 2003
  • In Korea, Private security companies has steadily grown and amounts to 2,051 places as of November 30, 2002. Private security in korea is carrying out firm name role assignment to have held the police and public peace environment change factors for a standard faithfully, and protects social a little property that is a basic purpose, and it is spare no efforts in loss prevention. In spite of numeral increase of private security companies, private security companies have many problem. Moreover, they mostly did not have any remarkable in-house expertises in their own business under tough conditions. Under the unfavorable circumstances including insufficient investment and education in private security guard, there have been actually little further studies on private security business in practices. So this study mainly focused on addressing the installation security business managed by authorized companies, which amount to 96%(1,963 companies) of total 2,051 domestic security companies. Furthermore, the study formulated and modeled a series of business procedures in private security companies. A series of business procedures of private security companies can be modeled as follows : Setting of a business scope and aim market ${\Rightarrow}$ Marketing, Contact from customers(On-line or Off-line) ${\Rightarrow}$ Diagnosis of security target ${\Rightarrow}$ Submission of security operational plan ${\Rightarrow}$ Estimation of security operational plan ${\cdot}$ decision ${\Rightarrow}$ Contract ${\Rightarrow}$ Employment, selection of security guards ${\Rightarrow}$ Nomination of security guard instructors ${\Rightarrow}$ Education & training of security guards ${\Rightarrow}$ subscribe to insurance of damage liability ${\Rightarrow}$ Commitment and placement of security guards ${\Rightarrow}$ Establishment and preparation of security planning ${\Rightarrow}$ Field management and procurement of relevant security service.

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Legal Considerations and Improvement Suggestions on Recreational Underwater Activity (수중레저활동에 대한 법적 고찰과 개선방안 연구)

  • Jeong, Kyong-Hwa
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.26 no.1
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    • pp.47-56
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    • 2020
  • This study analyzed the recreational scuba diving regulations in Korea and other foreign countries and it proposes five changes to improve the Act On The Safety, Promotion, Etc. Of Underwater Leisure Activities in Korea. First, "recreational underwater activity participant" should be modified to refer to 'an individual or group of individuals entering into a contract with a recreational underwater activity businessperson for their own use'. Second, the person setting up the recreational underwater activity zone should be expanded to 'recreational underwater activity businessperson and/or recreational underwater activity participant'. Third, since recreational technical diving uses nitrox or mixed gas, a clause should be added that a sticker or band clearly indicating the type of gas should be attached. Fourth, a Surface Marker Buoy (SMB) should be added to the diving equipment, and the daily management and maintenance of cylinders should be specified in detail. Fifth, it is necessary to specify in the Act that recreational underwater activity participants are encouraged to purchase diving insurance for their own use. In addition, for the safety of underwater activity participants, the Act must specifically state the emergency procedures and diving guidelines of a recreational underwater activity businessperson.

The recognition of development plan and what to pursue in dental laboratory industry (치과기공산업 발전 방안 및 추구해야 할 방안에 관한 인식도)

  • Kim, Kap-Jin
    • Journal of Technologic Dentistry
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    • v.39 no.2
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    • pp.119-128
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    • 2017
  • Purpose: In order to increase competitiveness for the growth and development of the dental laboratory industry, we plan to develop the dental laboratory industry. Methods: A total of 547 questionnaires were used as the final analysis data for the dental technicians from all over country participated in the 51st Korea Dental Technology Expo & Scientific Conference of the Korean Dental Technologist Association held in KINTEX from July 18 to 19, 2015. The questionnaire items consisted of 28 items in terms of general characteristics, questions about the methods to be pursued for the development of the dental laboratory industry, and recognition about the methods to be pursued to develop the dental laboratory industry. The collected data were analyzed by SPSS Ver. 21.0 for windows. Results: To improve the dental laboratory industry, actualization of dental laboratory products fee(41.2%) had the highest, followed by improving treatment of dental technician, standardization of dental laboratory products, direct bill of medical insurance, regulation of contract management on huge capital, and etc. The recognition of the measures to be pursued for the development of the dental laboratory industry was that dental laboratory products fee required to receive more than 20% of the dental prosthesis fee highest($4.62{\pm}0.76$). And to enlarge dental laboratories through M&A between dental laboratories is the lowest($3.39{\pm}1.26$). Conclusion: As a means to pursue the development of the dental laboratory industry, the actualization of dental laboratory products fee was proposed. Recognition also showed that dental laboratory products fee required to receive more than 20% of dental prosthesis fee was the highest. It is important to propose a reasonable dental laboratory products fee because it recognizes that it is necessary to promote economic growth in both development plan and awareness.

Guaranteed Reserve Projections for the Guaranteed Interest Contract of Collective DC Funds (통합운영 DC의 이율보증 준비금 추정에 관한 연구)

  • Sung, Joo-Ho;Seo, Dong-Won;Lee, Dong-Hwa
    • Journal of the Korea Society for Simulation
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    • v.28 no.3
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    • pp.57-63
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    • 2019
  • This study suggests the level of guaranteed reserves that should be accumulated in order to provide guaranteed interest contracts to pension members. To calculate the guaranteed reserve, this study employs the method using variable insurance contracts with guaranteed interest options. The average return of three major pensions (national pension, private teacher's pension, civil servants pension) funds, from 2010 to 2018, is set as the target rate of return and then we establish 0%, 1.0%, 1.5% and 2.0% each as our minimum guaranteed returns for their respective guaranteed reserves. Our results firstly show that gaps between each guaranteed reserves are increasing as times goes on. Second, the probability of shortfall reserve is on the decrease as the pension fund is mature. Conclusively, a long-term conservative balance between risk and return is one of the best investing strategies in pension funds providing the guaranteed interest.

Review of 2015 Major Medical Decisions (2015년 주요 의료판결 분석)

  • Yoo, Hyun Jung;Lee, Dong Pil;Lee, Jung Sun;Jeong, Hye Seung;Park, Tae Shin
    • The Korean Society of Law and Medicine
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    • v.17 no.1
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    • pp.299-346
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    • 2016
  • There were also various decisions made in medical area in 2015. In the case that an inmate in a sanatorium was injured due to the reason which can be attributable to the sanatorium and the social welfare foundation that operates the sanatorium request treatment of the patient, the court set the standard of fixation of a party in medical contract. In the case that the family of the patient who was declared brain dead required withdrawal of meaningless life sustaining treatment but the hospital rejected and continued the treatment, the court made a decision regarding chargeable fee for such treatment. When it comes to the eye brightening operation which received measure of suspension from the Ministry of Health and Welfare for the first time in February, 2011, because of uncertainty of its safety, the court did not accept the illegality of such operation itself, however, ordered compensation of the whole damage based on the violation of liability for explanation, which is the omission of explanation about the fact that the cost-effectiveness is not sure as it is still in clinical test stage. There were numerous cases that courts actively acknowledged malpractices; in the cases of paresis syndrome after back surgery, quite a few malpractices during the surgery were acknowledged by the court and in the case of nosocomial infection, hospital's negligence to cause such nosocomial infection was acknowledged by the court. There was a decision which acknowledged malpractice by distinguishing the duty of installation of emergency equipment according to the Emergency Medical Service Act and duty of emergency measure in emergency situations, and a decision which acknowledged negligence of a hospital if the hospital did not take appropriate measures, although it was a very rare disease. In connection with the scope of compensation for damage, there were decisions which comply with substantive truth such as; a court applied different labor ability loss rate as the labor ability loss rate decreased after result of reappraisal of physical ability in appeal compared to the one in the first trial, and a court acknowledged lower labor ability loss rate than the result of appraisal of physical ability considering the condition of a patient, etc. In the event of any damage caused by malpractice, in regard to whether there is a limitation on liability in fee charge after such medical malpractice, the court rejected the hospital's claim for setoff saying that if the hospital only continued treatments to cure the patient or prevent aggravation of disease, the hospital cannot charge Medical bills to the patient. In regard to the provision of the Medical Law that prohibit medical advertisement which was not reviewed preliminarily and punish the violation of such, a decision of unconstitutionality was made as it is a precensorship by an administrative agency as the deliberative bodies such as Korean Medical Association, etc. cannot be denied to be considered as administrative bodies. When it comes to the issue whether PRP treatment, which is commonly performed clinically, should be considered as legally determined uninsured treatment, the court made it clear that legally determined uninsured treatment should not be decided by theoretical possibility or actual implementation but should be acknowledged its medical safety and effectiveness and included in medical care or legally determined uninsured treatment. Moreover, court acknowledged the illegality of investigation method or process in the administrative litigation regarding evaluation of suitability of sanatorium, however, denied the compensation liability or restitution of unjust enrichment of the Health Insurance Review & Assessment Service and the National Health Insurance Corporation as the evaluation agents did not cause such violation intentionally or negligently. We hope there will be more decisions which are closer to substantive truth through clear legal principles in respect of variously arisen issues in the future.

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The Precaution Duty and the Product Liability for Adverse Reactions to the Contrast Media (조영제 부작용에 대한 주의의무와 제조물책임)

  • Kang, Yeong-Han
    • Journal of radiological science and technology
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    • v.30 no.4
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    • pp.305-311
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    • 2007
  • Contrast medium is a useful drug for radiological examinations and usability of it gradually increases while it has some inevitable adverse reaction and it is difficult to predict the occurrence and the degree of adverse reactions. Although the patient consented permission for the use of contrast media, the hospital could not be exempted from the responsibility for the adverse contrast media reaction. During radiological contrast media examination, the radiologist and the contrast media producer have the duty of precaution, prediction and avoid adverse results. In addition, they have reliabi lity of patient remedy for neglecting the duty. Since contrast medium are manufactured or processed as movable properties, the manufacturers are bound to the product liability if damages occur due to the defects in pharmaceuticals. In consideration of the characteristics of product liability, it is necessary to demand high degree of duty of care and diligence from producer or to reduce patient's burden of proof in a product liability lawsuit. For securing compensation ability and liability implementation, products compensation liability insurance is required for contrast medium manufacturers. In conclusion, contrast medium producer has legal liability for adverse reactions and the contract concluded with producer and hospital including legal liability will reduce liability of hospital and radiologist, patient.

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Analysis on Legal Issue of Lawsuits and Subjective Judgment on Defects in Apartment Building (공동주택 하자소송의 법률적 쟁점사항과 판정체계분석)

  • Park, Jun-Mo;Seo, Deok-Seok;Choi, Jeong-Hyun;Kim, Ok-Kyue;Park, Kang-Woo;Jo, Jae-Hun
    • Journal of the Korea Institute of Building Construction
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    • v.12 no.1
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    • pp.42-53
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    • 2012
  • Lawsuits related to defects in apartment buildings involve a range of legal issues, based on which the current subjective judgment system has been established. This study aims to organize the judgment system by stage of lawsuit from a legal perspective by reviewing the factors dealt with in precedent research. The main issues at hand include assignment of obligation, the day on which the computation of exclusion period begins and the day on which the defect repair is completed. The rationality of the current subjective judgment system could be determined by reviewing the recent cases. Based on the findings of the review, the following are suggestions for improvements and complements of the system. First, the process of assignment of obligation should be systemized, and the guarantee insurance system that provides a warranty deed should be improved as well. In addition, improvements and systemization should be made to clarify the responsibilities for any defect arising from the agreements that are not stipulated on the contract, computation of abatement rate of compensation and the system by which the responsibility for the defects is completed when residents acquire ownership from rental status.