• 제목/요약/키워드: Insurance data

검색결과 2,413건 처리시간 0.034초

The Effect of Increasing The Third Party Liability and Expansion of Mandatory Insurance in South Korea

  • KWAK, Young-Arm
    • 산경연구논집
    • /
    • 제12권11호
    • /
    • pp.33-50
    • /
    • 2021
  • Purpose: In South Korea, two kinds of mandatory insurance, Fierce Liability Insurance and Outdoor Advertising Liability Insurance sells as of February 2021 according to relevant codes. This study analyzed third party liability and personal living liability insurance in terms of various risks not corporation side but personal side arising from normal living and life. Research design, data and methodology: Some cases of drone accident hit man and fierce dog accident were taken into analysis to verify blame ratio and insurance claim money. The former case is that on the way down the elevator, the dog, American pit bull terrier rushed in and bit the lower part of the knee against the visitor. The latter case is that while flying in the sky as usual, the drone suddenly crashed, fell, and hit the head of a young child while walking on the street. Further previous studies such as third party liabilities, liability insurance, mandatory insurance were deeply analyzed. Results: Based on some case studies and previous studies, the author suggested valuable comments in turn realization of insurer as provider, exhaustive creation and operation of mandatory insurance, realization of insured as demanded, and arrangements of laws and systems in special consideration of amendment of companion animal and exhaustive execution of mandatory insurance by the government. Conclusions: This study was about third party liability, personal living liability insurance and expansion of mandatory insurance caused by relevant laws by the government. In this study the author verified what issues were observed from two cases drone accident and fierce dog accident and then suggested some valuable comment as above both systemic plans and practical plans. First of all, the individual should get Comprehensive Property Insurance(CPI) that covers the risks of his/her own property arising from the everyday life. And then the individual should further buy Personal Living Liability Insurance(PLLI) in order to prepare 'accidents that may happen when, where, or how' and overcome the said accidents. Moreover, the individual should take a look every single insurance contract whether he/she has a special terms and conditions of Personal Living Liability Insurance(PLLI) or not.

소아 천식을 통해서 본 의료보험 상병 자료의 완전성 추정 : Capture-Recapture 분석방법의 적용 (Completeness Estimation of the Korean Medical Insurance Data in Childhood Asthma : Using Capture-Recapture Method)

  • 하미나;권호장;강대희;조수헌;유근영;주영수;성주헌;강종원;김대성;이상일
    • Journal of Preventive Medicine and Public Health
    • /
    • 제30권2호
    • /
    • pp.428-436
    • /
    • 1997
  • Objectives : The purpose of this paper is to estimate the completeness of the Korean Medical Insurance Data in childhood asthma. Methods : Capture-recapture method was used to estimate the prevalence of childhood asthma and case ascertainment rate(completeness) of Korean Medical Insurance Data using two source model, 'Korean Medical Insurance Committee Data (KMICD)' and 'Nationwide Study of Asthma and Allergies in Korean Children'. The asthma cases were restricted to those who were born from 1981 to 1989 and were identified by their Resident Register Number. Asthma cases in Korean Medical Insurance Data were defined as cases coded by ICD-9 493 and ICD-10 J45. In 'Nationwide Study of Asthma and Allergies in Korean Children', asthma cases were defined as the children who had been diagnosed asthma and had experienced symptoms of asthma during the past 12 months. The defined cases in two data sources were matched by 13 digits Resident Register Number. The numbers of matched patients in two data sources were 245 of 32,825 eligible total subjects. Chapman and Wittes' nearly unbiased estimation was used for capture-recapture analysis of two data sources. Results : Observed prevalence rate of childhood asthma was 5.3% and estimated prevalence rate by capture-recapture analysis was 11.6%. The highest prevalence rate was observed in 6-7 age group and the older the rate decreased. The completeness (the proportion of cases ascertained by KMICD to the total observed cases by two data sources) was 20.6%, and ranged form 10.8% to 28.8% by area. Conclusions : Invalid diagnosis of cases might overestimate the prevalence of child-hood asthma and might underestimate the completeness of Korean Medical Insurance Committee Data in this study.

  • PDF

드론 보험제도 비교분석과 요구보험 도출 (Derivation of Required Insurance and Comparative Analysis of Drone Insurance System)

  • 최진헌;남두희
    • 한국ITS학회 논문지
    • /
    • 제19권6호
    • /
    • pp.144-151
    • /
    • 2020
  • 다양한 분야에 활용되는 드론은 2026년에는 사업용 드론 5만대를 예상하고 있다. 사업용 드론에 한해 영업배상책임보험 가입 의무 부과되고 있으나 드론의 사용 영역이 확대됨에 따라 기체임무에 따른 법적의무를 부과하는 드론 보험제도 개선이 필요하다. 특히, 드론의 기체 특성 다양화로 인해 위험도에 따른 보험체계가 필요하다. 이를 위해 국내 드론 운용 현황조사 및 국내외 드론 보험관련 문헌검토와 드론 관련 자료 수집 및 분석, 교통수단별 보험제도, 해외 드론 보험상품 자료 분석을 시행한다.타 교통수단의 보험체계를 기반으로 드론 사고특성을 적용한 기체특성별, 운용임무별 드론보험가입에 대한 드론 보험제도 개선안 도출하며 기체 특성별, 운용 임무별 보험기준 수립을 위해 이용자, 이용사업체, 보험회사 등 분야별 요구 보험 조사를 통해 시사점을 도출, 기체의 물리적 특성에 따른 위험도 산출을 통한 세부 보험기준을 수립하며 기체 운용 임무에 따른 손해배상 책임을 구체화 하였다.

A Study on the Factors Associated with the Success of CRM in the Insurance Company

  • Kang, Jung-Chul
    • Journal of the Korean Data and Information Science Society
    • /
    • 제15권1호
    • /
    • pp.141-172
    • /
    • 2004
  • This paper studied the theory and methodology of CRM for insurance business and perform empirical analysis to verify causes of success. It considered five factors as variables to explain success of CRM which are (1) Integration through the partnership among organization and members. (2) Utilization of customers' information. (3) Strategy through marketing channel and interaction with customers. (4) Investment and IT infrastructure to construct CRM system. (5) Interaction among organizations for CRM. The success is defined as four terms; effectiveness of organization, curtailment of cost, improvement of customer service and sale of insurance.

  • PDF

신포괄수가 시범사업 모형개선이 건강보험 보장률에 미친 영향 (The Effect of Reform of New Diagnosis-Related Groups on Coverage of National Health Insurance)

  • 최정규;김선희;장정하;윤종민;강중구
    • 보건행정학회지
    • /
    • 제30권2호
    • /
    • pp.178-184
    • /
    • 2020
  • Background: Korea set up a new diagnosis-related group as a demonstration project in 2009. The new diagnosis-related group was reformed in 2016. The main purpose of the study is to identify the effect of reform on coverage of national health insurance. Methods: This study collected inpatient data from a hospital that contains medical information and cost from 2015 July to 2016 June. The dependent variable was the coverage of national health insurance. The dependent variable was divided by total, internal medicine partition, surgical partition, and psychiatric partition. To analyze the effect of the reform, this study conducted an interrupted time series analysis. The final sample included 23,695. Results: The health insurance coverage of internal medicine has the highest, followed by surgery and psychiatry. The health insurance coverage of bundle payment is higher than that of unbundled payment. The proportion of bundled payment and non-benefit decreased and the proportion of unbundled payment increased. The coverage of national health insurance significantly increased after policy reform in internal medicine partition (p-value=0.0356). Conclusion: The results of the study imply that policy reform enhanced the coverage of national health insurance in internal medicine. The government needs to monitor side effects such as an increase of unbundled payment.

요양급여비용 산정기준의 지식수준과 건강보험 실무적용에 영향을 미치는 요인 (Factors Influencing the Knowledge of Health Insurance Standard and Health Insurance Application)

  • 이순영;임순연
    • 치위생과학회지
    • /
    • 제15권6호
    • /
    • pp.815-824
    • /
    • 2015
  • 이번 연구는 임상에 근무하고 있는 치과의사와 보험청구 담당자들의 건강보험관련 교육의 참여 실태를 파악하고, 교육경험이 그들의 요양급여비용의 산정기준에 대한 지식과 건강보험 실무 적용수준에 미치는 영향을 파악하고자 전국에 소재한 치과 병 의원에 근무하는 치과의사와 보험청구 담당자를 대상으로 설문 후 분석한 결과 다음과 같은 결론을 얻었다. 요양급여비용 산정기준에 관한 지식수준은 보험청구 담당자가 치과의사보다 높은 것으로 나타났다(p<0.01). 교육참여 횟수가 많을수록 보험청구 담당자의 요양급여비용 산정기준 지식수준이 통계적으로도 유의하게 높은 것으로 나타났고(p<0.001), 평균교육시간이 3시간 미만인 경우보다 3시간 이상인 경우 요양급여비용 산정기준에 대한 지식수준이 높게 나타났고, 통계적으로 유의한 차이를 보였다(p<0.05). 보험청구 담당자가 치과의사보다 건강보험 실무적용수준이 높은 것으로 나타났고, 통계적으로 유의한 차이를 보였다(p<0.001). 치과의사는 보험청구 경력이 많을수록 건강보험 실무 적용수준이 높은 것으로 나타났고(p<0.01), 보험청구 담당자는 연령이 적을수록, 교육 참여 횟수가 많을수록, 평균교육 시간이 길수록 건강보험 실무 적용수준이 높은 것으로 나타났다(p<0.05) 최근 3년간 건강보험관련 교육의 참여경험이 보험청구 담당자의 요양급여비용 산정기준 지식수준에 유의한 영향을 미치는 요인으로 나타났고(p<0.001), 보험청구 경력과 요양급여비용 산정기준 지식수준은 그들의 건강보험 실무 적용수준에 유의한 영향을 미치는 것으로 나타났다(p<0.01) 이러한 결과로 미루어볼 때 치과의사 및 보험청구 담당자의 건강보험에 관한 지식수준과 건강보험 실무적용 수준을 유지하기 위해서는 관련된 교육 관련된 교육을 지속적으로 받는 것이 필요할 것으로 판단된다.

자기공명영상의 건강보험 적용 전·후 이용량 동향 및 요인 분석 (Analysis of the Trend and the Factors Influencing the Usage Before and After the Application of the National Health Insurance for the Magnetic Resonance Imaging)

  • 길종원;최성욱
    • 한국산학기술학회논문지
    • /
    • 제17권8호
    • /
    • pp.477-484
    • /
    • 2016
  • 본 연구는 자기공명영상(MRI)의 건강보험 적용 전 후 이용량 동향과 이용량에 영향을 미치는 요인을 알아보기 위해 실시하였다. 연구재료는 2004년 1월부터 2013년 12월까지 대전광역시 소재 종합병원(2차 의료기관)의 MRI 실시자료(처방 정보 전달 시스템), 보험심사자료, 건강보험요양급여자료(건강보험심사평가원)를 이용하였고, 분석대상은 2004년(건강보험 적용 전) 3,754명, 2005년 - 2013년(건강보험 적용 후) 4,107명-8,630명 이었다. 분석은 이용자 특성(성별, 연령, 검사부위, 보험유형)과 공급자 특성(진료과, 진료형태)의 MRI 건강보험 적용 전 후 이용량 비교를 $X^2$ 으로 하였고, MRI 이용량에 영향을 미치는 요인분석을 위계적 다중회귀분석으로 실시하였다. 연구결과 건강보험 적용 초기에 한시적으로 이용량이 감소하지만 이후 꾸준히 증가하였다. 특히 여성의 검사 율, Head & Neck의 검사 율, 일반수가적용 환자의 검사 율, 내과의 검사율, 입원환자의 검사 율이 건강보험 적용 전에 비해 증가하였다. 그리고 MRI의 건강보험 적용은 검사 율 증가에 영향을 미치는 것으로 분석되었다(P<.0001). MRI 검사 율이 증가하는 만큼 국민의료비 감소를 위해 건강보험 적용 확대가 적극적으로 이루어져야 할 것이다.

수술수가의 적정성에 관한 연구 - 상대가격체계와 항목분류를 중심으로 - (A Study on the Propriety of the Medical Insurance Fee Schedule of Surgical Operations - In Regard to the Relative Price System and the Classification of the Price Unit of Insurance Fee Schedule -)

  • 오진주
    • 한국보건간호학회지
    • /
    • 제2권2호
    • /
    • pp.21-44
    • /
    • 1988
  • In Korea, fee-for service reimbursement has been adopted from the begining of medical insurance system in 1977, and the importance of the relative value unit is currently being investigated. The purpose of this study was to find out the level of propriety of the difference in the fees for different surgical services, and the appropriateness of the classification of the insurance fee schedule. For the purpose of this study, specific subjects and the procedural methodology is shown as follows: 1. The propriety of the Relative Price System(RPS). 1) Choice of sample operations. In this study, sample operations were selected and classified by specialists in general surgery, and the number of items they classified were 32. For the same group of operations the Insurance Fee Schedule(IFS) classified the operations into 24 separate items. In order to investigate the propriety of the RPS, one of the purpose of this study, was to examine the 24 items classified by the IFS. 2) Evaluation of the complexity of surgery. The data used in this study was collected The data used in this study was collected from 94 specialists in general surgery by mail survey from November I to 15, 1986. Several independent variables (age, location, number of bed, university hospital, whether the medical institution adopt residents or not) were also investigated for analysis of the characteristics of surgical complexity. 3) Complexity and time calculations. Time data was collected from the records of the Seoul National University' Hospital, and the cost per operation was calculated through cost finding methods. 4) Analysis of the propriety of the Relative Price System of the Insurance Fee Schedule. The Relative Price System of the sample operation was regressed on the cost, time, comlexity relative ,value system (RVS) separately. The coefficient of determination indicates the degree of variation in the RPS of the Insurance Fee Schedule explained by the cost, time, complexity RVS separately. 2. The appropriateness of the classification of the Insurance Fee Schedule. 1) Choice of sample operations. The items which differed between the classification of the specialist and the classification of medical, Insurance Fee Schedule were chosen. 2) Comparisons of cost, time and complexity between the items were done to evaluate which classification was more appropriate. The findings of the study can be summarized as follows: 1. The coefficient of determination of the regression of the RPS on-cost RVS was 0.58, on time RVS was 0.65, and on complexity RVS was 0.72. This means that the RPS of Insurance Fee Schedule is improper with respect to the cost, time, complexity separately. Thus this indicates that RPS must be re-shaped according to the standard element. In this study, the correlation coefficients of cost, time, complexity Relative Value System were very high, and this suggests that RPS could be reshaped I according to anyone standard element. Considering of measurement, time was thought to be the most I appropriate. 2. The classifications of specialist and of the Insurance Fee Schedule were compared with respect to cost, time, and complexity separately. For complexity, ANOVA was done and the others were compared to the different values of different classifications. The result was that the classification of specialist was more reasonable and that the classification of Insurance Fee Schedule grouped inappropriately several into one price unit.

  • PDF

보험 청구액에 대한 새로운 복합분포 (New composite distributions for insurance claim sizes)

  • 정대현;이지연
    • 응용통계연구
    • /
    • 제30권3호
    • /
    • pp.363-376
    • /
    • 2017
  • 보험 시장은 포화되고 그 성장 동력은 소진되어 보험 산업이 저성장에 머물러 있는 가운데 보험사들은 치열한 경쟁 환경에 놓여있다. 이러한 상황에서 보험 상품에 대한 보험수리적 계산의 기초가 되는 보험 청구액의 흐름을 잘 설명할 수 있는 확률분포를 찾아내는 것은 중요한 쟁점이 될 것이다. 보험 청구액의 분포는 일반적으로 두꺼운 꼬리를 가지면서 왼쪽으로 치우친 로그정규분포나 파레토 분포로 잘 설명된다고 알려져 있으나 최근에는 기운 정규분포나 기운 t 분포가 보험 청구액 분포로 적절한 것으로 고찰되었다. Cooray와 Ananda (2005)는 로그정규분포와 파레토 분포의 장점을 모두 가진 로그정규-파레토 복합분포를 제시하고 단일분포보다 더 높은 적합도를 가짐을 확인하였다. 본 논문에서는 기운 정규분포와 기운 t 분포를 머리 부분으로 결합한 새로운 복합분포를 소개하고 덴마크의 화재보험 청구액 데이터와 미국의 배상 지불금 데이터에 적용하여 기존의 다른 복합분포들을 포함하여 여러 단일분포들과 그 성능을 비교한다.

코퓰라를 이용한 강수의 패턴 분석과 강수 보험의 가격 결정 (Analyzing rainfall patterns and pricing rainfall insurance using copula)

  • 최창희;이항석;주효찬
    • Journal of the Korean Data and Information Science Society
    • /
    • 제24권3호
    • /
    • pp.603-623
    • /
    • 2013
  • 최근 들어 예측하기 힘든 기후의 변동성이 심해지고 한국의 산업이 고도화됨에 따라 날씨의 변화에 능동적으로 대처하기 위해 날씨보험이나 날씨 파생상품을 활용할 수 있으나 현재 실제로 이러한 금융상품을 이용하여 날씨위험을 관리하는 데에는 많은 어려움과 한계가 있다. 본 논문에서는 다양한 강수보험의 활성화에 필요한 강수횟수와 강수량의 확률적 모델링을 통하여 여러 가지 강수 보험을 제안하고 추정된 결합분포를 통하여 보험료를 산출하려 한다. 이를 위하여 최근 30년 동안 한국 9개 지역의 7월-9월의 월 강수량과 월 강수 횟수를 확률분포에 적합하고 두 확률변수의 상관성을 코퓰라를 이용하여 분석한다. 그리고 개별분포와 추정된 코퓰라를 이용하여 시뮬레이션을 통하여 여러 가지 강수 보험의 가격을 결정하는 방법을 제안한다.