• Journal of the Korea Convergence Society
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• v.13 no.3
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• pp.217-225
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• 2022

We analyzed efficiency and productivity of the Indian non-life insurance market affected by the COVID-19 pandemic from 2020. Using data envelopment analysis(DEA), we examined non-life insurance companies selling health insurance products in India from FY2013 to FY2019. We found the followings. First, average efficiency of the entire non-life insurance industry worsened in the beginning yet improved later. Second, analyzing the efficiency measures by group, we found that private insurance companies had the highest efficiency, followed by state-run insurance companies and pure health insurance companies. Third, average annual productivity growth rate of companies operating distance selling channels including telemarketing is higher than that of traditional face-to-face channels. During and after the COVID-19 pandemic, therefore, Indian non-life insurance companies should focus their resources and efforts on the development of distance selling channels when establishing business strategies. Besides, it would be interesting to extend our analysis to the post-coronavirus period and we leave this for future research.

• The Korean Society of Law and Medicine
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• v.14 no.2
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• pp.11-41
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• 2013

Article 347 of criminal law provides the act of deceiving another, thereby taking property or obtaining pecuniary advantage from another. On the other hand, the concepts of fraud and abuse are confused upon interpretation since the definition in National Healthcare Insurance Law is unclear, and it affects closely to the administrative measures such as surcharge levy by the period of inspection, therefore, the disputes continue in the forms of formal objection, administrative ruling and administrative litigation. This study aims to look over the legal problems on application of criminal fraud toward the abuse of 'Paid Medical Expenses(Article 57, Sections 1 and 4 of the National Health Insurance Act)'. The main issues are concept of abuse(Article 57, Sections 1 and 4 of the National Health Insurance Act), the problems of Directions of Health-Welfare Ministry on aspect of 'Nullum crimen sine lege' Principles, the proper sentenc-ing guidelines of fraud.

• Journal of the Korea Institute of Building Construction
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• v.13 no.2
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• pp.102-111
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• 2013

During the administration of a construction project, various types of participants are engaged in the project. From the design phase to the maintenance phase, these participants may confront many risks. To avoid these risks, participants should utilize an insurance company or a bond company. The types of risks and liability that a construction manager may face are listed in the construction law or contract. But there are some arguments related to risk transferring and the content of risks. For this reason, construction managers must carefully consider any possible risks in the contract and the construction law. Therefore, for construction managers to deal with risks appropriately, the introduction of a legal requirement to carry professional liability insurance, a defined compensation range for damages, a method of guarantee in the event of defects, a defined compensation claim period for damage, and a method of damage claim were suggested in this study.

• Journal of Technologic Dentistry
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• v.38 no.1
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• pp.9-22
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• 2016

Purpose: The Purpose of this study are to describe the Dental field of present health insurance for custom-made prosthetic implant by dental technicians' work. Results: A total of 300 dental technicians working at dental laboratories in Korea were randomly selected and surveyed, 206(68.7%) of them were used for the statistical analysis. Conclusion: Average daily working time was 10 hours 66%. The average cumulative credit of the clinic for dental prosthesis fabrication rates was Less than 10 million won(21.8%), 10~80 million won(11.7%), more than one hundred million won(1.5%). Remake dental prosthesis was one more than the monthly average of 98.5%. Causes of remake dental prosthesis was dentist impression 83% but did not pay 62.5%. Dental technicians Implant production period was 7 days(48.5%), 10 days(35%) was commissioned by dentists production time is 5 days(46.1%), 7 days(36.5%). President of dental laboratories 3.86 points and dental technicians 3.06 points knew differently about starting of implant health insurance coverage(p<.001). They alike were in favor of insurance coverage for the implant. Dental technicians were lower by 2.36 points for work do you know whether your health insurance application of dental prostheses. Dental technicians are 2.16 points on whether confidence in the pores payment of insurance coverage dental prosthesis, dental laboratory president was lower by 1.85 points. They are very low with 1.97 points on whether confidence in the rate payment of health insurance coverage dental prosthesis(p<.01). The implant prosthesis abutment selected, the abutments designed, design of the implant upper prosthetic, the upper prosthetic fitting dental technicians participate of dental laboratory president showed higher score (p <.05). Conclusion: Hours of dental technicians were making this short period of remake dental prosthesis-related dental prosthesis. Dental clinic and a detailed representation of the dental prosthodontic fabrication request is required for communication between the laboratory in order to reduce the remake of a dental prosthesis, dental insurance coverage written dental prosthodontic fabrication request should be legislated. Implant classification standard medical practice 1-3 Step conduct a thorough costing a total of no. 73 of the correct classification standard medical practice in addition to eight times defined by the act of dental technicians should be defined.

• Journal of Acupuncture Research
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• v.38 no.2
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• pp.146-158
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• 2021

Background: This study was designed to statistically analyze the year, gender, age, insurance type, and condition/disease of patients who were admitted to the Department of Acupuncture and Moxibustion Medicine at DaeJeon Korean Medicine Hospital over a 5-year period (2015-2020). Methods: Patients who visited the Department of Acupuncture and Moxibustion Medicine at DaeJeon Korean Medicine Hospital were classified according to year, gender, age, insurance type, and condition/disease. The statistical analysis was performed using IBM SPSS 23.0. Results: There is an increasing number of patients attending the Department of Acupuncture and Moxibustion Medicine year-on-year over the 5-year period, with a higher frequency of females than males each year. The largest age groups represented in these patients were those aged in their 50s, followed by those aged in their 40s, and 60s. Furthermore, the number of patients using health insurance was greater than those using automobile insurance each year. Of the 5,061 patients, the most common group was the patients (n = 991) who reported sprain and strain of cervical spine, followed by lumbar spine, lumbar herniation of the intervertebral disc, and facial paralysis. Conclusion: The number of patients seeking traditional Korean medicine treatment continues to increase, particularly in the 40s to 60s age group, with a larger proportion using health insurance and sprain or strain of the cervical spine. The results of this study may be used as a local (Daejeon) reference to develop Korean medicine policies, such as setting up medical benefits for patients using Korean medicine hospitals.

• Journal of agricultural medicine and community health
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• v.16 no.2
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• pp.179-194
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• 1991

Despite its universal coverage of health insurance, the rural health insurance program(RHIP) stands at the crossroads in Korea. The RHIP has weaknesses in stability of financing, problems of inequities in the provision of health services and has suffered from high cost of running the program. The author has analyzed these problems from the perspective of health insurance policy and presented several options for improvement. First of all, this study urged the importance of a firm Governmental commitment of RHIP with the 50% subsidization of contributions as the Government had promised, instead of the current 40%. This can be justified from the 20% subsidization by the Government for the contributions of private school teachers and their dependents, who belong to richer segments of the population. Second, various cost containment measures ought to be sought curbing the rising demand for medical through strengthening health education and increasing individual responsibility, and tightening the claim review process. Third, this study requires the Government to run a demonstration project on the introduction of case payment system for primary health care. Fourth introducing an income-related cost sharing scheme is another possibility. Reforming the cost sharing formula for large medical expenditures is recommendable for a beginning. This measure can take the form of tax credit for medical expenditures of the poor. Fifth, the degree of financial adjustment among health insurance plans should be levelled up for enhancing stability of RHIP and social solidarity. Sixth, health policy should be redirected toward development of rural health resources and higher priority should be put on relieving difficulties in access to care. Seventh. the insurance plan owned-hospital needs to be developed or provision of health services in the medically underserved areas, and the need of such facilities is particularly acute for geriatric care, rehabilitation and renal dialysis, etc. Eighth, more generous insurance benefits are required of the elderly who are suffering the most : elimination of the maximum 180 days of benefit period and provision of glasses and artificial dentures, etc. Ninth. the economies of scale principle is working for the operating expenses of regional self-employed insurance plan. Thus, measures should be instituted to pursue an optimum size of health insurance plans. Lastly, excessive dependence on exclusion items is an evil so that some radical remedies are urgently required to cut them.

• The Journal of Korean Medicine
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• v.30 no.4
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• pp.64-78
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• 2009

Objectives: To research Korean oriental medical doctors' use of uninsured herbal extracts and how to bring about the insurance coverage of such herbal extracts. Methods: We surveyed Korean oriental doctors about the following issues from October 17th to November 15th, 2008: (1) Korean oriental medical doctors' knowledge about herbal extract insurance and the circumstances of oriental medicine in Korea, (2) their opinion on the coverage of currently uninsured herbal extracts and the dispensing of herbal extracts from pharmacies rather than from their clinics, (3) their use of herbal extracts, and (4) how to bring about insurance coverage of uninsured herbal extracts. Results: Over 70% of the respondents said that herbal medicine prescriptions have been reduced recently and that the existence of herbal medicine is in danger. In addition, 63.64% respondents agreed with expanding insurance coverage to include currently uninsured herbal extracts in spite of the fact that patients might have to obtain herbal extracts from pharmacies rather than from Korean oriental medical clinics. The average patient number per month of uninsured herbal extracts was 13.64 people, the average dosage was 5.64g, the average cost per day was 3,859 won, and the average prescription period was 2.65 days. Korean oriental medical doctors asked an average of 12,486 won for the medical examination-prescription fee and 3,292 won in fees for prescriptions obtained outside the hospital. If insurance coverage expands to include these herbal extracts, their usage is expected to increase 2.31 times. Conclusions: This study shows Korean oriental medical doctors' use of herbal extracts and their opinions about execution of herbal extracts' insurance. A periodic study such as this one will hopefully aid in establishing polices for uninsured herbal extracts' insurance.

• Journal of Fisheries and Marine Sciences Education
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• v.26 no.5
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• pp.1044-1057
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• 2014

This study has seen about a indemnity system of fishery damage by natural disasters such as a problem and improvement methods of government aid system and system on accident insurance for cultured fishery products. Recently, in the situation that the demage of aquaculture industry caused by frequent typhoon resulted from global warming and abnormal changed of weather is nasty, the accident insurance for cultured fishery products is necessary to show its true quality and to protect fishers against natural disasters owing to the limitation of government's aid for them. However, The objects of accident insurance for cultured fishery products which is progress on, is too short to apply, so that it is absolutely insufficient to fulfill the demands of culturing fishermen. Therefore, It could be a certain preparation to magnify the range of object items of it and to convert the trial industry being adjusted to limited area into full scale industry to adjust over all nationally. Furthermore, This insurance is complicated and strict to join rather than other insurances. As it can be seen by examples that got in trouble, despite culturing fishermen applied to join the insurance, they took all demage because the insurance was not realized. So, It is hard to say that causes impute the responsibility of it to the authority of insurance, not culturing fishery. They should simplify the registration process, limit the period each registration process and consider a countermeasure to complete it. Concerning compensation for the loss, agriculture part is easier to investigate the loss due to remained dead crop damaged by natural disaster, meanwhile, in fishing part, especially in case of cultivation of fish, it is difficult to investigate the loss and demage because crops are blown all together with typhoon when it comes plus the facilities of them are also very old. Consequently to solve the problem needs more positive attitude as it is policy insurance.

• Health Policy and Management
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• v.23 no.2
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• pp.132-144
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• 2013

Background: The purpose of this study was to analyze the medical expense change and influencing factors after introducing longterm care insurance system. The study period was 2 years before and after introduction of the system. Methods: We analyzed data collected from two divided group lived in Incheon. Four hundred and eighty-five elderly who received long-term care wage for one year were selected for experimental group. For control group, 1,940 elderly were selected by gender and age stratified random sampling. Difference-In-difference analyses was used for evaluating policy effectiveness. Also multiple regression analyses were conducted to identify the factors associated with total medical expenditures. The control variables were demographic variables, economic status, diseases, and medical examination variables. Results: Difference-in-difference analyses showed that total average medical expenses among long-term patients has decreased by 61.85%. Of these, the hospitalization expenses have decreased by 91.63% and the drug expenses have increased by 31.85%. Multiple regression analyses results showed that total average medical expenses among long-term patients have significantly decreased by 46.5% after introducing the long-term care insurance. The hospitalization expenses have significantly decreased by 148.5%, whereas the drug expenses have increased by 53.6%. And outpatient expenses have increased by 10.4%, but the differences were not statistically significant. Conclusion: The results showed that total medical expenses and hospitalization expenses have decreased after introducing the long-term care insurance. These results could support the opinion that the health insurance spending among long-term patients will be reduced gradually by long-term care insurance through changing medical demand.

• Journal of Labour Economics
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• v.26 no.2
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• pp.31-59
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• 2003

This paper analyzes a social insurance system that integrates unemployment insurance with a pension program, allowing workers to borrow against their future wage income to finance consumption during an unemployment episode and thus improving their search incentives while reducing risks. This paper identifies the conditions under which the integration improves welfare and the factors which determine the optimal degree of integration. A fully integrated system is one in which no reliance is placed at all on a separate tax-funded unemployment insurance program. We show that when the duration of unemployment is very short compared to the period of employment or retirement, the optimal system involves an exclusive reliance on pension-funded self-insurance. This system imposes a negligible risk burden for workers while avoiding attenuating search incentives. We also argue that a joint integration of several social insurance programs with a pension program through an individual account is desirable unless the risks are perfectly correlated to each other.