• 경영과정보연구
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• 제26권
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• pp.261-291
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• 2008

The EU holds about 50% of exports and imports in the world trade of services. The insurance markets have undergone a significant consolidation in solvency rule, cross-border registration, and standardized accounts. In the EU-Korea FTA negotiations the EU is interested in mutual certification of qualifications as well as market liberalization of law, finance and distribution and so forth. When the negotiation with respect to the mutual certification of qualifications comes to a settlement, the two countries will drive it in service areas. Korea should examine european certification regulations and improve domestic insurance-related institutions. France is the focal country of the EU. The paper provides a comparative study of insurance markets and agents in France and Korea. The paper argues that Korea should initiate institutional changes and be transformed into an insurance service exporting country for the specialized insurance agents to move to EU countries.

• Asia pacific journal of information systems
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• 제32권3호
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• pp.496-513
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• 2022

Artificial intelligence or big data technologies can benefit finance companies such as those in the insurance sector. With artificial intelligence, companies can develop better customer segmentation methods and eventually improve the quality of customer relationship management. However, the application of AI-based customer segmentation in the insurance industry seems to have been unsuccessful. Findings from our interviews with sales agents and customer service managers indicate that current customer segmentation in the Korean insurance company relies upon individual agents' heuristic decisions rather than a generalizable data-based method. We propose guidelines for AI-based customer segmentation for the insurance industry, based on the CRISP-DM standard data mining project framework. Our proposed guideline provides new insights for studies on AI-based technology implementation and has practical implications for companies that deploy algorithm-based customer relationship management systems.

• 한국IT서비스학회지
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• 제6권2호
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• pp.1-18
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• 2007

Many researches have been done in insurance fraud as the amount and frequency of insurance fraud have been increasing continuously. In particular, the development of insurance fraud detection system using large database management techniques including data mining or link analysis based on visual method have been the main research topic in insurance fraud. However, this kinds of detection system were very ineffective to find unintentional insurance fraud happened by accident even though it was so good to find intentional and organized crime insurance fraud. Therefore, this research suggests insurance fraud as an ethical decision making and applies TPB(Theory of Planned Behavior) for the finding of reasons and prevention strategies of unintentional insurance fraud happened by accident. The results of research show that TPB is very appropriate model to explain the behavior of insurance fraud and that insurance agents force to do insurance fraud as affecting perceived behavior control. Therefore, education and pubic relations for insurance fraud are very effective for preventing insurance fraud and developing insurance service industry.

• 한국임상약학회지
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• 제21권3호
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• pp.193-207
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• 2011

Purpose: The purpose of this study is to assess appropriateness of current standard for insurance coverage by Health Insurance Review & Assessment Service (HIRA) on chemotherapy used in the treatment of advanced non-small cell lung cancer (NSCLC), by reviewing a variety of clinical evidences, and thereby, if needed, to propose an updated evidence-based recommendations. Methods: We collected data from HIRA regarding on the insurance standard which includes the scope and conditions for coverage on systemic chemotherapy of NSCLC. We performed a search for clinical databases and examined the most current clinical evidence from clinical literature including various clinical practice guidelines. Based on the collected data the appropriateness of HIRA standard for insurance coverage of chemotherapy of NSCLC was assessed. Results: Collected data demonstrated that HIRA standard did not reflect the most current clinical practice and evidence. Some were inappropriately listed in HIRA formulary and accepted as a chemotherapy being covered by insurance, despite the lack of evidences of clinical efficacy or superiority over other chemotherapeutic agents or regimens. In addition, there seems to be a need for a modification on the standard for insurance coverage of certain newer chemotherapeutic agents based on the current accumulated data showing their clinical efficacy and benefits in the selected group of NSCLC patients. Therefore, we concluded that current HIRA standard for insurance coverage on chemotherapy of NSCLC needs to be revised and we proposed an updated recommendation based on these latest clinical evidences. Conclusion: The standard for insurance coverage of chemotherapy should be continually examined its appropriateness based on the most recent clinical evidences in a timely manner so as to provide the most effective and safe therapy to cancer patients.

• 벤처창업연구
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• 제11권2호
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• pp.121-134
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• 2016

현재 보험시장은 비대면(非對面)채널 성장에 따른 대면채널의 기여도 감소와 대면채널 유지측면에서 고비용이 소요되는 현실적인 문제에 직면해있다. 이에 따라 설계사 조직의 생산성 향상 즉 보험설계사의 성과 향상요인이 무엇인지를 실증하는 것이 본 연구의 목적이다. 보험설계사의 성격요인과 개인-환경적합성이 직무만족도, 이직의도에 미치는 영향을 고찰해 본 결과 설계사의 외향성, 성실성, 개방성, 원만성, 정서성, 정직성을 나타내는 성격요인은 조직몰입과 직무만족에 유의한 영향을 미치고 있다. 즉, 보험설계사의 성격이 활기차고 외향적이며, 다른 사람과의 공감성이 높을수록 회사에 강한 소속감을 갖고 몰입하는 정도가 높아진다고 할 수 있다. 이는 설계사의 도입 단계에서부터 선별 도입이 이루어져야할 필요성을 대변하고 있다. 반면 성격요인은 이직의도에는 유의한 영향을 미치지 아니하였다. 이는 설계사의 이직은 개인의 성격에 의하여 발생하는 것 보다는 개인성격 외의 요인에 영향을 받고 있음을 실증한 결과이다. 상사적합성, 직무적합성, 동료적합성, 조직적합성을 나타내는 개인-환경적합성은 조직몰입, 직무만족, 이직의도 모두에 유의한 영향을 미치고 있다. 즉, 상사나 동료와 가치관이나 성격, 일하는 방식 등이 비슷하고, 자신의 일이 적성에 잘 맞으며 조직과의 적합성이 높을수록 회사에 대해 소속감을 갖고 몰입하는 정도가 높아진다고 할 수 있다. 또한 교육을 통하여 보험 설계사의 성격에 따른 조직몰입과 직무만족도를 향상시킬 수 있음을 알게 되었다. 이는 교육이 설계사를 좀 더 긍정적인 측면의 외향성을 갖게 하고 성실하게 본인의 업무를 처리하게 하며 윤리적 영업이 가능하게 함을 시사한다. 본 연구의 성과는 보험설계사를 대상으로 실시한 성격요인과 직무만족도, 이직의도에 대한 최초의 실증연구결과이다.

• 보험의학회지
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• 제32권2호
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• pp.33-38
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• 2013

Coronary artery diseases are very important agenda in the insurance medicine. Insurance medicine is defined as using medical knowledge for insurance administration such as underwriting, claims, and customer satisfaction. This review article contains review of coronary artery disease in terms of insurance medicine. Estimation of extra-risks for acute myocardial infarction are MR of 349% and EDR of 41‰. In medical underwriting, individual life applicants can be assessed by Framingham's CHD risk assessment model. In claims, medical claims review is a useful method of consulting for claims staffs. Several diagnostic criteria of acute myocardial infarction are introduced in time. The universal definition of myocardial infarction by ESC/ACCF/WHF was demonstrated the most valuable predictor of 10-year mortality. Contents for State-Of-The-Art of the coronary artery disease are current antithrombotics. There are many novel anti-thrombotic agents such as ticagrelol, dabigatran, rivaroxaban, and pegnivacogin.

• 한국임상약학회지
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• 제22권4호
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• pp.291-303
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• 2012

As respiratory tract infections (RTI) account for about 60% of all antibiotic prescriptions in outpatient care setting, there are significant concerns about emerging resistance that are largely due to the excessive or inappropriate use of antibacterial agents for viral respiratory infections. This study was aimed to develop retrospective drug utilization review (DUR) program of antibiotics for RTIs using Delphi methods. Retrospective DUR criteria of antibiotics for RTIs were identified based on clinical practice guidelines and opinion of experts. Expert panel members were clinical doctors and pharmacists and Delphi method was applied by survey on 16 members of panels. The claim data from Korean Health Insurance Review & Assessment (HIRA) were used to examine trends in outpatient antibiotic prescription between Janunary to December of 2008. As results, Quality index for RTI was assessed for the claim type, antibiotics use of quantity, duration, number and cost. Antibiotic prescription rate for RTIs, Defined Daily Dose (DDD), and duration of antibiotics use were more recognized as significant quality index by experts' opinion. Use of first line agents suggested by guidelines was low and duration of antibiotics use was shorter compared to the recommendations. Antibiotics were over prescribed for RITs. However, dose and duration of antibiotics were under-used.

• 무역상무연구
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• 제44권
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• pp.111-180
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• 2009

According to English law, in a voyage policy there is an implied warranty that at the commencement of the voyage the ship shall be seaworthy for the purpose of the particular adventure to be insured. However, Unites States law affords the implied warranty of seaworthiness a great deal of latitude. In the case of voyage policies, it has been traditionally held that the assured is bound not only to have his vessel seaworthy at the commencement of the voyage but also to keep her so, insofar as this can be achieved by himself and his agents, throughout the voyage. Additionally, a defect in seaworthiness, arising after the commencement of the risk, and permitted to continue from bad faith or want of ordinary prudence or diligence on the part of the insured or his agents, discharges the insurer from liability for any loss consequent to such bad faith, or want of prudence or diligence; but does not affect the insurance contract in reference to any other risk or loss covered by the policy, and which is not caused or exacerbated by the aforementioned defect. One of the most important areas of difference in the marine insurance contract between the U.K. and U.S. is the breach of warranty. Prior to the Wilburn Boat case, the MIA was thought to hold that the effect of a breach of warranty was similar under American law -in that under the general maritime law literal compliance with all promissory warranties is required. In this case, the Court concluded that state law should apply to a marine insurance policy, and found that there was no federal rule addressing the consequences of a breach of warranty in marine polices. However, it is of the utmost importance that this case brought to a close the imperative concordance between English and American law. Meanwhile, in relation to marine insurance contracts in Korea, this insurance is subject to English law and practice;, additionally, the international trade volume between Korea and the United States has assumed a vast scale. Therefore, we believe it is important to understand the differences in marine insurance law between the two countries in terms of marine insurance contracts, and most specifically warranties.

• 보험의학회지
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• 제17권
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• pp.21-30
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• 1998

인슐린의존형당뇨병 환자의 혈당조절의 방법으로 먼저 식이요법과 운동이 권장되며, 이러한 방법으로 혈당조절이 만족스럽지 않을 때 경구혈당강하제를 사용하는 것은 혈당조절과 합병증 예방에 중요한 역할을 할 수 있다. 국내에서는 경구혈당강하제로 설폰요소제, 비구아나이드제인 메트포르민(metformin) 및 알파글루코시다제(${\alpha}$-glucosidase) 억제제인 아카보스(acarbose) 등이 사용되고 있다. 새로 개발중인 트로글리타존, 지방산 산화 억제제 등의 약제는 아직 임상에서 널리 사용되고 있지는 않다.

• 한국임상약학회지
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• 제31권1호
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• pp.27-34
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• 2021

Objective: To analyze osteoporosis treatment patterns and teriparatide prescription-associated factors in Korea by using a national health insurance claims database. Methods: We utilized the Health Insurance Review & Assessment Service National Patients Sample claims database to identify patients (aged ≥50 years) with at least one osteoporosis claim (International Classification of Disease 10th revision code: M80, M81, M82) and at least one prescription for osteoporosis medication (antiresorptive agents: bisphosphonates, selective estrogen receptor modulators, denosumab, and calcitonin; bone-forming agent: teriparatide) in 2018. Demographic characteristics and healthcare utilization patterns were analyzed. Factors associated with teriparatide prescriptions were assessed using a multivariate logistic regression model. Results: Records showed that 44,815 patients were prescribed osteoporosis medications in 2018; the percentage of patients prescribed each treatment was as follows: 86.6% bisphosphonates, 13.9% selective estrogen receptor modulators, 3.1% calcitonin, 2.1% denosumab, and 0.7% teriparatide. A greater proportion of patients prescribed teriparatide were ≥75 years (53.4% vs. 33.8%) and had fractures (63.9% vs. 12.8%) compared to the same for antiresorptives (p<0.001). Patients prescribed teriparatide had higher Charlson comorbidity index values (1.2±1.3 vs. 0.9±1.2) and were more frequently hospitalized (0.8±1.3 vs. 0.1±0.5) than those prescribed antiresorptives (p<0.001). Elderly patients (≥75 years old; adjusted OR=1.66; 95% CI 1.16-2.38) and those with fractures (adjusted OR=6.23; 95% CI 4.76-8.14) were more likely to be prescribed teriparatide than antiresorptives. Conclusion: Patients prescribed teriparatide were older and more likely to have severe osteoporosis than those prescribed antiresorptives.