• 제목/요약/키워드: claims

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클레임보험의학 (Claims Insurance Medicine)

  • 이신형
    • 보험의학회지
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    • 제30권2호
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    • pp.8-11
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    • 2011
  • Insurance medicine has been known to medical risk selection. The role of insurance medicine is sound maintenance of insurance system. So it's function is medical underwriting of life risks. However, emerging market has insufficient medical epidemiological research that is necessary for estimation of extra-risk and such market is usually lack of full understanding of life insurance among insurance customers. This problem makes difficult of performing the medical underwriting, as an original insurance medicine. Medical contributions at the stage of claims adjudication comparing the coverage provided in the product, with the information provided in the claims, based on medical records and the agreement between them. This is called medical verification. The insurance doctors can also use their medical knowledge to help the claims staff with informing claimants about the medical basis of claims decisions.

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보험의학적 악성도평가 (Differentiation between malignant and benign in terms of insurance claims)

  • 이신형
    • 보험의학회지
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    • 제32권1호
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    • pp.21-27
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    • 2013
  • In case of neoplasm claims, it is important to make a decision of differentiating malignant and benign. In Korean insurance market, there are many insurance products that cover cancer. In the insurance claims adjustment, differentiation between malignant and benign is according to histologic findings. However there are many neoplasms of bad clinical course in spite of benign histopathologic classification. In this article; astrocytoma, thymoma, gastrointestinal stromal tumor, colonic intramucosal carcinoma, gastric high grade adenoma/dysplasia, carcinoid tumor, MALT lymphoma, revision of Korean Classification of Disease-6th edition, and bladder tumors are reviewed in terms of differentiation between malignant and benign in the insurance claims. It may be helpful for claims staff to review important neoplasms in terms of differentiation between malignant and benign.

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사용자 클레임에 대응하는 건물유지관리체계의 효율성 분석 (Efficiency Analysis for Maintenance Management System of Users' Claims in Building)

  • 곽노열;임동순
    • 대한설비공학회:학술대회논문집
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    • 대한설비공학회 2006년도 하계학술발표대회 논문집
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    • pp.820-825
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    • 2006
  • It is necessary to correspond to building users' claims rapidly as much as possible in order to satisfy user's need, because the final tarket of building maintenance service is user of building. This paper investigates the time taken for receiving users' claims and the time taken for the service organization to respond to the claims in the office building; types of claims and service responses are analysed, through which the response characteristics of the maintenance management organization are evaluated with respect to users' claims. Throughout extensive simulation analysis, important performance measures such as mean time to repair and utilization of maintenance personnels have been investigated.

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PROPOSING MANAGEMENT OF WORK PRIORITY TO REDUCE CONSTRUCTION FAILURE CLAIMS

  • In-ho Kim;Moon-Seo Park;Hyun-Soo Lee
    • 국제학술발표논문집
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    • The 1th International Conference on Construction Engineering and Project Management
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    • pp.1171-1176
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    • 2005
  • Dispute related to construction projects involving numerous persons is one of the biggest challenges faced by contractors today. It costs a substantial amount of money and time in resolving these kinds of claims. Recently, with the changes in the construction environment and thought of relation with owner, the number of construction claims has increased. But, a majority of these claims do not prevail, and in fact, frequently get dismissed in its entirety. The reasons for such dismissals include the ignorance about the claims, lack of clear and convincing evidence, and so on. But most of reasons are the claims are not managed well on construction process. This paper analyzes the failure causes by relying on past claim failure cases, and then drew works that have connection with failure causes through interview. It also presented importance degree of construction management works.

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현장여건상이로 인한 클레임의 예방에 관한 연구 -공공부문의 설계$\cdot$시공일괄공사를 중심으로- (A Study on the Prevention for Differing Site Conditions Claims - Focused on Design-Build Project in Public Sector -)

  • 정명우;이화영;서용칠;현창택
    • 한국건설관리학회:학술대회논문집
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    • 한국건설관리학회 2001년도 학술대회지
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    • pp.46-53
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    • 2001
  • 정부의 지속적인 사회간접시설의 건설로 많은 대형공공공사가 발주되고 있으며, 이에 따라 많은 건설 클레임이 발생되고 있으며, 그 .중에서도 현장여건상이 클레임은 발생가능성이 높은 부분이다. 특히 현장여건상이 클레임은 여타 클레임과 달리 공사 초기에 발생하여 여타의 클레임보다 큰 손실을 초래할 수 있으므로 이에 대한 예방방안의 필요성이 증대되고 있다. 본 연구는 국내의 대형공공공사 중 일괄공사계약으로 발주된 공사에서 발생한 현장여건상이 클레임의 원인을 분석하고, 향후 이러한 클레임을 예방할 수 있는 예방방안을 제시하였다. 본 연구에서 제시하고 있는 예방방안으로는 첫째 수급자의 입찰관행 개선, 둘째 수급자의 현장조사 책임한계 정립, 셋째 발주자의 면책조항 재검토 그리고 마지막으로 계약금액 조정의 유연성을 확보하기 위한 방안 등을 제시하고 있다. 또한 상기의 예방방안에 대한 단·장기적 대안도 제시했다. 이러한 예방방안들은 발주자와 수급자 사이에서 현장여건상이 클레임의 해결에 사용될 수 있을 것으로 판단된다.

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An Empirical Study on Trade Claim Management from a Relational Perspective

  • Yu, Cheon
    • Journal of Korea Trade
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    • 제23권6호
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    • pp.14-32
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    • 2019
  • Purpose - This study is designed to provide new insights on trade claim management by typifying trade claims from a relational perspective, which defines trade as an organic combination that exchanges relationships based on a mutual goal instead of conflicts between obligations and rights of the contracting parties. Design/methodology - This is a phenomenological study that aims to typify trade claims based on a relational perspective and extract implications for trade claim management. The research procedures of this study are as follows. First, international commercial dispute cases applying the CISG are collected. Second, the cases collected are quantified through content analysis. The variables for quantification are developed based on a relationship perspective. Third, cluster analysis is conducted on coded data to typify cases. And finally, this study compares the characteristics of each type using analysis of variance and suggests implications for the strategic management of trade claims from a relational perspective. Findings - Results show that trade claims are divided into four clusters, depending on whether flexibility is accepted or not and which party violates mutuality. There is also a difference between the claimant and the cause of the claim, according to the cluster. Based on the results, this study suggests that the buyer and the seller should employ different strategies depending on the type of trade claim and presents proposals for strategic claim management. Originality/value - Firstly, this study extends the theoretical discussion on trade claims by applying relational contract theory. Prior studies on trade claims have been primarily based on traditional contract theory. The second is to analyze trade claims quantitatively. Prior case studies on trade claims have mainly relied on qualitative research. Finally, the study contributes to international commercial practice by typifying trade claims and presenting options for strategic management.

실내디자인 업무의 클레임 현황과 분쟁사례 분석에 관한 연구 - 실내건축가를 대상으로 한 실무사례를 중심으로 - (A Study on the State of Claims and Disputes in Interior Design Projects - Focusing on Practices and Experiences of Interior Designers -)

  • 이소영;김욱선
    • 한국실내디자인학회논문집
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    • 제27권3호
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    • pp.116-125
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    • 2018
  • With rapid economic development in Korea, interests in interior design have increased gradually. However, interior design markets were poorly evaluated from 2015 Korean Consumer Evaluation. It is necessary to identify what kinds of problems, defects, and consumer claims have arisen during interior design planning and construction procedures. Therefore the purpose of this study is to investigate claims and disputes in interior design project procedures and to find out when defects or claims take place in those procedures in order to reduce claims or defects. Email questionnaires were distributed to KOSID members (professional interior designers) using Google Survey. In addition, a focus group interview was conducted. A total of 54 responses were collected and analyzed using SPSS 19. As a result, in an agreement stage, alteration in materials is the major source of claim. More than a half of respondents addressed time shortage for programming and planning. During the construction stage, approximately 31% respondents experienced client dissatisfaction with materials and finishes. The reason for project completion delay was due to claims during construction. The claims most frequently appealed by clients were related to painting. The satisfaction with project quality is positively related to the quality and contents of design documents including design drawings and specifications. Regulations and communication with clients are important issues to reduce the gaps between interior designers and clients/ consumers.

건축턴키공사 초기 단계에서의 클레임 방지를 위한 클레임요인 분석 및 대응방안에 관한 연구 - 국내공사 사례중심으로 - (A Study of Analyzing Claim Factor and Making Strategies to Prevent Claim in Early Stage for Architectural Turn-key Project - Focusing on Domestic Project -)

  • 윤준선;유병억
    • 한국건축시공학회지
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    • 제6권1호
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    • pp.93-99
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    • 2006
  • In the inner turn key constructions the problems of uniform types are repeatedly occurred, and, especially, many problems happen up to the stage of pre-construction(from a bid to a contract) owing to the specialties of the turn key constructions. So the claim factors of the Korean turn key constructions were abstracted through the literature searches, the site document examinations, the case studies and the interviews with the experts. When the technicians meeting the interior turn key constructions for the first time and working here now are well acquainted with only these factors, many claims will be prevented. By analysing the degree of claims by claims factors through the questionnaires to the experts about the abstracted factors and surveying the amount of the claims through the case studies, what factors exerted how much of influence on the claims was tested and analyzed. Proposing the response devices to the factors affecting the claims much led the technicians in charge of internal turn key constructions to the prevention and the proper solution of the site claims.

건축턴키공사 입찰.계약 단계에서의 클레임 예방을 위한 클레임요인 분석 및 대응방안에 관한 연구 - 국내대형건축턴키공사 사례중심으로 - (A Sduty of Analyzing Claim Factor and Making Strategies to Prevent Claim in Bidding and Contracting Stage for Architectural Turn-Key Project)

  • 윤준선;백준홍
    • 한국중재학회지:중재연구
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    • 제13권2호
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    • pp.353-376
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    • 2004
  • In the inner turn key constructions the problems of uniform types are repeatedly occurred, and, especially, many problems happen up to the stage of pre-construction(from a bid to a contract) owing to the specialties of the turn key constructions. So the claim factors of the Korean turn key constructions were abstracted through the literature searches, the site document examinations, the case studies and the interviews with the experts. When the technicians meeting the interior turn key constructions for the first time and working here now are well acquainted with only these factors, many claims will be prevented. By analysing the degree of claims by claims factors through the questionnaires to the experts about the abstracted factors and surveying the amount of the claims through the case studies, what factors exerted how much of influence on the claims was tested and analyzed. Proposing the response devices to the factors affecting the claims much led the technicians in charge of internal turn key constructions to the prevention and the proper solution of the site claims.

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COMPARATIVE ANALYSIS ON TIME SERIES MODELS FOR THE NUMBER OF REPORTED DEATH CLAIMS IN KOREAN COMPULSORY AUTOMOBILE INSURANCE

  • Lee, Kang-Sup;Kim, Young-Ja
    • 한국수학교육학회지시리즈B:순수및응용수학
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    • 제11권4호
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    • pp.275-285
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    • 2004
  • In this paper, the time series models for the number of reported death claims of compulsory automobile liability insurance in Korea are studied. We found that IMA${(0, 1, 1)}\;{\times}\;{(0, 1, 1)}_{12}$ would the most appropriate model for the number of reported claims by the Box-Jenkins method.

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