• 제목/요약/키워드: claim factors

검색결과 174건 처리시간 0.022초

공기지연에 따른 클레임 대응방안에 관한 연구 - 지체상금을 중심으로 - (A Study on a System of Resolving Claim according to the Delay of Construction Projects - Focus on Liquidated Damages -)

  • 이영민;이상범;김정길
    • 한국건축시공학회:학술대회논문집
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    • 한국건축시공학회 2002년도 학술.기술논문발표회
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    • pp.111-116
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    • 2002
  • The delay of the completion of the construction project occurs frequently because the origin schedule is affected by numerous factors that contribute to the overall delay in completing the project. But in our country. the dealing with a claim is not sufficient yet by reasons of fairl relation between owner and constructor, cognitive shortage in claim, and such. especially they have make a wrong application of baseless the rule. In this study. we make a rational model ; that includes calculating of dispute costs, and suggest the solution and the prevention for claim by considerating the law followed liquidated damages.

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의료보험 진료비 지급 지연요인 - 병원요인과 보험자 요인을 중심으로 - (A Study of the Factors Causing Delayed Reimbursement of Medical Insurance Benefit)

  • 손명세;이영두;전기홍
    • Journal of Preventive Medicine and Public Health
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    • 제22권2호
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    • pp.259-267
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    • 1989
  • The objective of this study was to analyze the influence of the hospital and insurer in causing delayed reimbursement of medical insurance benefits. We analyzed major variables at three different sized hospitals to examine the effect of the hospital and insurer using the two-way ANOVA method. The results were as follows: 1. The time interval between claim by hospitals and payment of the benefit was statistically different according to hospital in both admission and outpatient care. 2. The time needed by the insurer for investigating the claims was statistically different according to hospital and insurer in both admission and outpatient care. There was interaction between the hospital and insurer factors in outpatient care. 3. Although there was interaction between the hospital and insurer factors in admission care, the time interval between claim and payment was statistically different. In outpatient care, the payment interval between claim and payment was also statistically different according to the hospital and insurer.

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Green Advertisement with Sustainability Claims -Message Credibility and Design Trendiness-

  • Yoo-Won, Min;Sae Eun, Lee;Kyu-Hye, Lee
    • 패션비즈니스
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    • 제26권6호
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    • pp.82-93
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    • 2022
  • Sustainability is a significant change that fashion industry has undergone. Marketers and brands are looking for guidance in green advertising to most effectively motivate consumers to purchase sustainable fashion products. This study aims to reveal environmental and cultural sustainability claims on message credibility and purchase intention regarding product trendiness. We performed mediation and moderation analyses, using a 2 (sustainability message: environmental and cultural) × 2 (product design: classic vs. trendy) between-subjects experimental design. The PROCESS MACRO was used for the analysis. Results indicate that environmental claim must appear credible to consumers to motivate them to purchase a product. On the other hand, cultural claim, with and without credibility, affected consumer's purchase intention. Moreover, cultural claim and trendy design together influenced message credibility and purchase intention, showing a moderated mediation effect. The study indicates that brands should broaden their perspective regarding sustainability by considering cultural factors when providing sustainability claims. Environmental claim should be clear and transparent to avoid green skepticism. Also, it is important to focus on product's design aspect: making trendy designs. It is difficult to change consumer behavior based only on sustainability value. Thus, brands must coney their consideration of design trends. Theoretical and managerial implications also are discussed.

의료기관과 심사기관의 심사업무인식도 비교연구 - 종합병원 청구직원과 건강보험심사평가원심사직원을 중심으로 - (A Comparative Study on Awareness of Review Work of Medical Institutions and Review Institutions - Focusing on Insurance Claim Officers at General Hospitals and Review Officers at Health Insurance Review Agency -)

  • 이수연;하호욱;손태용
    • 한국병원경영학회지
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    • 제9권3호
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    • pp.71-97
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    • 2004
  • This study conducted a comparative analysis of awareness level of review standards, continuing education, and awareness about the need for speciality and educational courses in order to improve quality of Korean health insurance review work and to present directions for policies of personnel development and continuing education to smoothly perform hospital's insurance claim work and Agency's review work. The analysis unit of the study is individuals, and survey was conducted among hospital's claim officers and Agency' review officers by distributing questionnaires. The major results of the study are as follows: First, it is found that hospital's claim officers and Agency's review officers have conflicting awareness about review standards; more Agency's review officers think that current review standards are universal and reasonable, while more hospital's claim officers believe that they need to be revised. Especially, hospital's claim officers replied that it is possible that review results can differ according to government's policies. Second, there is no significant difference between the two groups in the opinion that there are individual differences in awareness level of review standard. In particular, both groups share the opinion that review results can differ according to officer's interpretation of review standards. Third, Both review officer groups feel the need for further training and continuing education. Fourth, there is no difference between the two groups in the opinion that both groups members should be educated in review related educational institutions. However, while 81.5% of Agency's review officers the education should be offered at the Agency, only 45.2% of hospital's claim officers agreed to it. Fifth, both review personnel do not show any difference in awareness of needed experience to successfully perform review work; both groups replied that three to four years experience is necessary to smoothly perform claim work and review work. This study was tried in order to search for directions to improve Korean insurance review work in quality rather than to explore characteristics themselves of individual factors. In this sense, this study presupposed an intention that the educational subjects for further training and continuing education for the two groups should be the same in order to narrow the awareness gap between hospital's claim officers and Agency's review officers. Thus, this study suggests that it is desirable to offer beginner courses at junior colleges or in undergraduate courses and advanced courses in professional graduate school for six to twelve months. In that a comparison of awareness level of hospital's claim officers and Agency's review officers who are actually in practice should precede appropriate presentation of directions for the qualitative improvement of insurance review work in Korea, the significance of this study lies in comparatively analyzing the awareness level of hospital's claim officers and Agency's review officers and in presenting the establishment of future further training and continuing education.

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설계시공 일괄입찰공사에서 설계변경 클레임요인의 분석에 관한 연구 (A Study on the Analysis of Change Order - Claim in Design-Build)

  • 이상범;황재우
    • 한국건설관리학회:학술대회논문집
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    • 한국건설관리학회 2006년도 정기학술발표대회 논문집
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    • pp.301-304
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    • 2006
  • 국제적으로 자유무역협정(FTA)에 따른 건설시장의 개방으로 인해 계약상의 권익 주장이 일반화되고 있으며 계약당사자들 간의 분쟁이 빈번히 발생하고 있다. 건설산업의 계약조건은 타 산업과는 다른 특수성을 지니므로 각 공사별로 공종, 환경, 주변 여건 등의 특성을 판단하여 별도의 계약 조건을 설정해야 한다. 국내에서도 공사규모의 증대와 복합기능의 요구에 따라 Design-Build의 발주가 확대되고 있으나 이에 적합한 계약규정이 정해져 있지 않고, 일반공사에서 사용되는 공사계약 일반조건의 일부규정에만 따르고 있어 설계변경 시 여러 가지 클레임 요인들이 발생하고 있는 실정이다. 건설시장 개방이라는 현안을 능동적이고 효과적으로 대처하기 위해서는 국제기준에 부합되는 설계변경 관련 건설 계약규정 및 제도 개선이 요구되므로, 본 연구에서는 이를 위한 객관적이며 합리적인 설계변경 클레임 발생요인의 유형분류와 분석을 통하여 정성적인 클레임요인들을 정량화시켜 D/B사업단계별 설계변경 관련 클레임의 주 요인에 대한 구체적인 분쟁 대응방안을 제시하였다.

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Basic Research on Nuclear Power Plant Construction Claims and Dispute Management Processes Development

  • Son, HyeJin;Lee, SangHyun;Byon, SuJin
    • 국제학술발표논문집
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    • The 6th International Conference on Construction Engineering and Project Management
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    • pp.710-711
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    • 2015
  • A nuclear power plant construction is a complex form of construction which comprises various stakeholders and contractors. Therefore, contract disputes will occur due to conflicting interests of contracting parties and unpredictable factors which arise during construction work. Even if the contract is well prepared, it cannot fully prepare for future situations in actuality. Claims management is very important in carrying out construction management. This study intends to define claim, and delve into development of claims management processes from the viewpoint of owners and contractor through consideration on international contract terms on claims management and the details of the claims management of the Construction Extension to the PMBOK. In addition, it is needed to accumulate and manage data on claims that have occurred so that they can be referenced in the future. As information should be accumulated so that type classification can be carried out and that lessons can be learned on claims that have occurred in each business site, study on establishing data-based systems relating to claims processes will be needed in the future.

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건강보험청구자료에서 동반질환 보정방법 (Comorbidity Adjustment in Health Insurance Claim Database)

  • 김경훈
    • 보건행정학회지
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    • 제26권1호
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    • pp.71-78
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    • 2016
  • The value of using health insurance claim database is continuously rising in healthcare research. In studies where comorbidities act as a confounder, comorbidity adjustment holds importance. Yet researchers are faced with a myriad of options without sufficient information on how to appropriately adjust comorbidity. The purpose of this study is to assist in selecting an appropriate index, look back period, and data range for comorbidity adjustment. No consensus has been formed regarding the appropriate index, look back period and data range in comorbidity adjustment. This study recommends the Charlson comorbidity index be selected when predicting the outcome such as mortality, and the Elixhauser's comorbidity measures be selected when analyzing the relations between various comorbidities and outcomes. A longer look back period and inclusion of all diagnoses of both inpatient and outpatient data led to increased prevalence of comorbidities, but contributed little to model performance. Limited data range, such as the inclusion of primary diagnoses only, may complement limitations of the health insurance claim database, but could miss important comorbidities. This study suggests that all diagnoses of both inpatients and outpatients data, excluding rule-out diagnosis, be observed for at least 1 year look back period prior to the index date. The comorbidity index, look back period, and data range must be considered for comorbidity adjustment. To provide better guidance to researchers, follow-up studies should be conducted using the three factors based on specific diseases and surgeries.

영국 보험법 상 보험자의 보험금지급의무와 관련한 주요 쟁점 - 2015년 보험법 상 개정내용을 중심으로 - (Main Issues on the Insurer's Duty of Payment of Insurance Claim in English Insurance Law -Focused on the Revised Provisions in Insurance Act 2015 -)

  • 신건훈;이병문
    • 무역상무연구
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    • 제76권
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    • pp.125-145
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    • 2017
  • Where an insurer has unreasonably refused to pay a claim or paid it after unreasonably delay, the existing law in England does not provide a remedy for the insured. Accordingly, the insured is not entitled to damages for any loss suffered as a result of the insurer's unreasonable delay. This legal position differs from the law in Scotland and most major common law jurisdictions. LC thought that the legal position in England is anomalous and out of step with general contractual principles. LC considered that a policyholder should have a remedy where an insurer has acted unreasonably in delaying or refusing payment of claim, and, therefore, recommended a statutory implied term in every insurance that the insurer will pay sums due within a reasonable time and breach of that term should give rise to contractual remedies, including damages. More detailed recommendations of LC are as followings. First, it should be an implied term of every insurance contract that, where an insured makes a claim under the contract, the insurer must pay sums due within a reasonable time. Secondly, a reasonable time should always include a reasonable time for investigating and assessing a claim. Although a reasonable time will depend on all the relevant circumstances, for example, the following things may need to be taken into account, that is, (1) the type of insurance, (2) the size and complexity of the claim, (3) compliance with any relevant statutory rules or guidance, and (4) factors outside the insurer's control. Thirdly, if the insurer can show that it had reasonable grounds for disputing the claim(whether as to pay or not, or the amount payable), the insurer does not breach the obligation to pay within a reasonable time merely by failing to pay the claim while the dispute is continuing. In those circumstances, the conduct of the insurer in handling the dispute may be a relevant factor in deciding whether the obligation was breached and, if so, when. Fourthly, Normal contractual remedies for breach of contract should be available for breach of the implied term to pay sums due within a reasonable time. Finally, In non-consumer insurance contracts, the insurer should be permitted to exclude or limit its liability for breach of the obligation to pay sums due within a reasonable time, unless such breach was deliberate or reckless, and such an insurer's right to contract out will be subject to satisfying the transparency requirements.

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지역의료보험(地域醫療保險) 재정지출(財政支出)의 결정요인(決定要因) (Determinant Factors for Expenditure of the Medical Insurance Program for Self-Employeds)

  • 감신;박재용;예민해
    • Journal of Preventive Medicine and Public Health
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    • 제28권1호
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    • pp.153-174
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    • 1995
  • This study was conducted to examine the determinant factors for expenditure of the medical insurance program for self-employeds based on the analysis of 1991 'The Medical Insurance Program for Self-Employeds Statistical Yearbook', and also similar yearbooks in the metropolitan and other provinces. The major findings are as follows : We have divided benefits into these four components such as the utilization rate for out-patients, expenses per claim for out-patients as paid by the insurer, utilization rate for in-patients, and the expenses per claim for in-patients as paid by the insurer, in order to examine the determinant factors for it. The results of the study revealed the following findings, in urban areas, the supply of medical care had more influence on the benefits than other demographic and economic variables, while, in county areas, both the supply of medical care and the rate of those aged over 65 affected the provision of benefits. The determinant factors for financial balance of the medical insurance program for self-employeds are, first, the determinant factor for administrative expenses was the number of households. The more the number of households, the less the administrative expenses per the insured. This shows that the economy of scale is being. And so, the administrative district must be taken into consideration in the incorporation of small regional medical societies and should be re-organized for more efficient management. Second, in urban areas, the supply of medical care had more influence on utilization rate and expenses per claim as paid by insurer, and therefore it is necessary to control it. In county areas, the supply of medical care and the rate of those aged over 65 raised the utilization rate and expenses per claim as paid by insurer. For the financial stability of county areas, a common fund for medical care for the aged and expansion of finance stabilization fund would be necessary. But, in county areas, it would be unnecessary to control the supply of medical care because it was much more insufficient than in urban areas. The vitalization of public health facilities must be carried out in county areas, for they reduced benefits. Sice the more insured in a single household, the less the utilization of the medical insurance program, benefits for habilitation at home should be given consideration. The law of majority and the economy of scale were applied here, and therefore the incorporation of regional medical societies must be taken into consideration. In integrating regional medical societies, it would be absolutely necessary to review the structural differences among all regional medical societies, the medical demand of each region, and also the local characteristics of each region.

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환경 역동성과 전략적 기술자원의 보호: 한국 하이테크 전자기업의 우선권주장출원 (Environment Dynamism and Strategic Technology Resource Protection: Claims of Priority of Korean High-tech Electronics Firms)

  • 김도윤;신동엽
    • 지식경영연구
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    • 제22권1호
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    • pp.57-84
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    • 2021
  • 본 연구는 21세기형 초경쟁 환경에서 지속가능한 경쟁우위를 위해 전략적 자원인 기술자원을 보호하기 위한 기업의 시도에 영향을 미치는 요인들을 실증 연구한다. 이를 위해 본 연구는 전략경영의 자원기반관점과 거시 조직이론의 관점에서 기업들이 불확실하고 급변하는 환경에 대응하여 신속하고 강력하게 자신의 혁신적 기술을 보호하는 동시에 경쟁자들의 기술탐색을 제한할 수 있는 제도인 '우선권주장출원'이라는 기술보호전략의 실행에 영향을 미치는 시장 환경요인들을 분석한다. 본 연구에서는 기업들이 특허출원이라는 기술혁신 성과를 보호하기 위한 일반적 전략을 넘어서서, 더 강력한 경쟁전략인 우선권주장출원을 왜 선택하는지, 그리고 이 강화된 기술자원 보호전략이 어떻게 경쟁자들을 견제할 수 있는지에 대해, 대표적인 초경쟁 산업인 대한민국 하이테크 전자기업들 특허데이터와 재무데이터를 이용하여 실증 연구한다. 1994년부터 2008년까지 우리나라 하이테크 전자기업들이 출원한 특허출원 데이터와 재무데이터를 기반으로 한 실증분석의 결과, 기업들의 우선권주장출원전략을 실행하는 것은 외생적 충격과 환경불확실성에 의해 부정적인 영향을 받는 반면, 시장변동성에 의해 긍정적인 영향을 받는 것으로 나타났다. 또한 각 기업의 지위는 위 세 가지 요인들의 영향을 약화시키는 방향으로 조절효과를 가지는 것으로 나타났다.