• Strategy21
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• s.45
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• pp.91-115
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• 2019

When compared to land territorial claims, maritime claims have not attracted as much attention from the public as well as the academia. However, after the ICOW (Issue Correlates of War) data was published and was expanded to include maritime and river claims, there have been many quantitative studies that analyze maritime claims or separate different types of territorial claims to explain various mechanisms over different types of territorial claims. These quantitative studies have provided valuable explanations about the onset and the management of maritime claims. This research tries to review these quantitative research. Most studies about maritime claims, especially regarding the management of claims, analyze maritime claims based on two different levels of factors. First, from the perspective of systemic level, several studies focus on the role of international institutions and systemic level of democracy to explain the management of maritime claims. Second, at the dyadic level, many studies explain how the issue salience, past experience, the presence of resources, joint democracy, and relative power influence the occurrence of peaceful settlement attempts or conflictual behaviors over maritime claims. Based on the review of these literature, this research tries to identify several factors to explain the Dokdo issue and to encourage peaceful settlement attempts over the Dokdo issue.

• International conference on construction engineering and project management
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• 2022.06a
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• pp.57-66
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• 2022

Claims and disputes are major causes of cost and schedule overruns in the construction business. In order to manage claims and disputes effectively, it is necessary to analyze various types of contract documents punctually and accurately. Since volume of such documents is so vast, analyzing them in a timely manner is practically very challenging. Recently developed approaches such as artificial intelligence (AI), machine learning algorithms, and natural language processing (NLP) have been applied to various topics in the field of construction contract and claim management. Based on the systematic literature review, this paper analyzed the goals, methodologies, and application results of such approaches. AI methods applied to construction contract management are classified into several categories. This study identified possibilities and limitations of the application of such approaches. This study contributes to providing the directions for how such approaches should be applied to contract management for future studies, which will eventually lead to more effective management of claims and disputes.

• Journal of Preventive Medicine and Public Health
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• v.28 no.3 s.51
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• pp.640-650
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• 1995

After the introduction of National Medical Insurance in 1989, the medical demand has rapidly increased. The impact of increased medical demand was followed by an increase in the number of claims in need of review. We studied a new, fair method for reducing the number of claims reviewed. We analysed 90,583 outpatient claims submitted between September and October; claims were made for services given August of 1994. We finally suggested a screening system for claims review using a statistical method of discriminant analysis of the medical costs. The results were as follows. 1. In the cut-off group, age, days of medication, number of hospital or clinic visits, and total charge were significantly high. The cut-off rates according to the hospital-type and existence of accompanied disease were significantly different 2. According to ICD, the cut-off rate was highest in peripheral enthesopathies and allied syndromes(20.76%), lowest in acute sinusitis(0.93%). The mean charges were significantly different according to ICD and existence of cut-off. 3. We build discriminant functions by ICD with such discriminant variables as patient age, sex, existence of accompanied disease, number of hospital or clinic visits, and 9 detailed hospital or clinic charges included in claim. 4. We applied the discriminant function for screening those claims that were expected to be cut-off. The sensitivities comprised from 40% to 70%, and specificities from 70% to 95% by ICD. Acute rhinitis had highest sensitivity(100.00%) and other local infections of skin and subcutaneous tissue had highest specificity(98.45%). The expected number of cut-off was 17,762(19.61%). The total sensitivity was 49.62%, the total specificity was 82.57% and the error rate was 19.66%. We lacked economic analysis such as cost-benefit analysis. But, if the new method of screening claims using discriminant analysis were applied, the number of claims in need of review will reduce considerably.

• Journal of the Korea Society of Computer and Information
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• v.22 no.1
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• pp.99-106
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• 2017

In this paper, the first to identify in detail the direct and indirect causes of trade claims and to provide a way to prevent the causes and measures specific claims. Trade claims is not the best way to prevent in advance, measures to prevent future trade claims is as follows. First, it should be the credit investigation of the counterparts. Second, the contract must determine the rights and obligations of each other through sufficient consultation with contract and faithfully perform its contractual obligations. Third, the explicit trade arbitration clause of arbitration in the contract, and shall be a sufficient review of the procedure such as import and export, international business practices, norms and partners of economic policy, foreign exchange regulations, the trade system transactions. Finally, for it is to be treated as a one-stop strengthening the organization and function, and the Ministry of Commerce and Trade Association, and KOTRA and Trade Insurance Corporation strategic support systems, such as done by covering the work on trade claims prevention and resolution in the Korean Commercial Arbitration Board.

• Journal of Preventive Medicine and Public Health
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• v.16 no.1
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• pp.121-127
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• 1983

To identify the changes in professional services pattern after introducing the deligated system of claims review started in 1982, a university hospital under this system was examined. For comparison, claims of the hospital to Federation of Korean Medical Insurance Societies, where this system is not accepted, were reviewed. A total of 600 cases each were studied operated at the Departments of General Surgery & Orthopedic Surgery in 1981 and 1983. The results are summarized as follow: 1. Percentages of hospital charges for basic care was decreased by 10.2% and that for medical service increased by 8.4% in 1983. 2. After the introduction of the deligated review system, percentages of cutting off the claims was decreased by 12.4% for basic care and increased by 3.8% for medical services. 3. Percentage of testing liver function, and the frequency of administering high cost intravenous fluid injection, applicating Robinul as anesthetic premedication were decreased respectively after introducting the deligated services system.

• The Journal of the Korean life insurance medical association
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• v.32 no.1
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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.

• Journal of Korean society of Dental Hygiene
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• v.15 no.3
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• pp.353-361
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• 2015

Objectives: The purpose of the study is to investigate the level of knowledge and screening review rates of dental health insurance claims in dental hygienists. This analysis will provide the educational information to the dental hygienists. Methods: A self-reported questionnaire was completed by dental hygienists in Jeonbuk from December 17, 2012 to January 24, 2013. The questionnaire was distributed by ordinary mail or direct visit. Except incomplete answers, 350 data were collected and analyzed. The study instrument was adapted from the structured questionnaire by Hong and Yoo. The questionnaire consisted of education experience of health insurance management, subjective and objective knowledge, insurance screening review, and need for health insurance education. Data were analyzed by SPSS 12.0 program. Cronbach alpha in the objective knowledge on health insurance rate criteria was 0.836 and this was a reliable figure. Results: The subjective knowledge level of dental insurance was higher in the senior dental hygienists. Subgingival curettage was the lowest percentage of correct answers in the objective knowledge. In recent six months, higher review control rate was shown in the higher claim for health insurance and insurance screening review. Conclusions: The majority of the respondents had lower level of knowledge of health insurance claims. The continuous education of dental health insurance will be necessary in the dental hygienists.

• THE INTERNATIONAL COMMERCE & LAW REVIEW
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• v.53
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• pp.207-229
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• 2012

In IP 7 and LCCP 201, Law Commission considers the insured's duty of good faith after the formation of the contract. This article intends to review and analyse the legal implications of proposals in IP 7 and LCCP 201. The results of analysis are following. First, Law Commission propose to end the remedy of avoidance under MIA 1906 section 17, because avoidance of past claims is unprincipled, impractical and unnecessarily harsh. Secondly, LC proposes that an insured who makes a fraudulent claim should forfeit the whole claim which the fraud relates, but that the fraud should not invalidate previous and legitimate claims. Thirdly, LC proposes to introduce a statutory right for the insurer to claim damages for the reasonable, foreseeable costs of investigate a fraudulent claim in specific circumstances and that damages would be limited to those cases where the insurer can show an actual, net loss. Finally, LC provisionally propose that an express fraud clause should be upheld in business insurance, whereas in consumer insurance, any term which purports to give the insurer greater rights in relation to fraudulent claims that those set out in statute would be of no effect.

• The Journal of the Korean life insurance medical association
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• v.27 no.1
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• pp.33-36
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• 2008

BACKGROUND : The medical claims review(MCR) is unique methodology of medical consultation in terms of insurance claim administration in Korean insurance market. The most important practical matter in the MCR is formatted question. In Korea, medical specialty is composed of 26 legally defined hospital departments. It is worth of studying to investigate type of MCR by hospital departments. METHODS : Fifty Cases of the MCR were selected randomly by statistical program SPSS among 1,032 cases which were performed between April 1, 2006 and March 31 2007. All of selected cases were evaluated one insurance doctor and made a score points from 0 to 10 in terms of hospital department. RESULTS : Multidimensional scaling was performed. The MCR types - diagnosis, malignancy and cause of death are located in the same 2-dimensional configuration area. It can be called as verification of benefit. Others are advice. - such as causality, interpretation, translation, independent medical examination, and so on. DISCUSSION : We can conclude the classification of MCR typology are two main subjects, verification and advice. Theses results are same as previous article which was based on experience.

• THE INTERNATIONAL COMMERCE & LAW REVIEW
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• v.49
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• pp.189-212
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• 2011

As the international business increases among the nations of the world recently, it is an inevitable fact that its claims rise as well. The most reasons of the international business claims have been concentrated upon the unpaid issues. The other reasons are sequently the different interpretation of business contract's conditions, the inferior quality of the goods, the breach of shipping time, the uncertain market-claims and some problems of transportation, the quantity and bad package of the goods. As business transactions grow more complex, it becomes increasingly important to resolve claims as quickly and efficiently as possible. Recognizing the importance of comprehensive policy support for overall international trade and investment of local company in recent years, Korean government has reborn the Korea Insurance Corporation ("K-sure"). K-sure adopted a range of measures to improve management efficiency to strengthen national competitiveness and national economy by promoting oversea trade and investment. Especially, K-sure will be able cover not only export transactions but also import transactions to secure oversea natural resources and commodities vital the national economy. K-sure should be able to continue and expand the existing export insurance programs, support import transactions and lead export-oriented industrialization of Korea as the best trade insurance agency.