• Title/Summary/Keyword: 보험료 청구

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Introduction and Application for Advanced Group Underwriting Skill (단체보험 언더라이팅 선진기법 도입방안)

  • Kim, C.N.;Back, J.K.;Lee, S.H.;An, J.W.;Chung, S.W.;Lee, S.M.;Jang, J.H.
    • The Journal of the Korean life insurance medical association
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    • v.22
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    • pp.139-169
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    • 2003
  • 국내 보험 산업은 경제발전에 따라 많은 성장을 이루어왔으나 단체보험은 보험 회사의 외부적 또는 내부적 환경으로 인해 활성화가 미흡한 상황이다. 개인보험시장의 포화, 해외시장에서 단체보험의 지속적인 성장, 사회보험 민영화 논의, 방카슈랑스와 보험시장의 개방 등 급격한 변화를 겪고 있는 보험영업환경을 고려한다면 향후 확대될 기업복지시장에서의 성공적 역할수행을 위해서는 단체보험 영업과 지원시스템의 보완이 시급한 과제라고 할 수 있다. 특히 언더라이팅 기법은 단체보험의 핵심역량이며 회사의 경쟁력 강화와 사차익 안정화를 위해서는 단체보험 인수기법의 선진화가 필수요건이다. 단체보험은 대수의 법칙, 수지상등의 원칙 등 보험의 기본원리라는 측면에서는 개인보험과 다른 점이 없지만 하나의 계약을 통해 집단의 피보험자에게 보장을 제공하기 때문에 가지게 되는 역선택 축소, 비용절감, 기업에 의한 1차선택 등 몇 가지 특성들은 인수기법에서의 차이를 필요로 한다. 하지만 국내의 단체보험 언더라이팅은 기본개념조차 제대로 정립되어 있지 못한 초기단계로 단체보험의 특성을 제대로 반영할 수 있는 위험평가를 위해서는 선진기법의 도입이 절실하다. 첫째, 자유보장한도(FREE COVER LIMIT)의 도입이다. 자유보장한도는 단체에 대한 위험과 피보험자 개인의 위험을 구분하는 기준으로 자유보장한도내의 피보험자에 대해서는 고지나 의적 검사를 요구하지 않고 개인별 언더라이팅을 하지 않으며 거절체나 표준하체이더라도 자유보장한도 금액까지는 나머지 정상 피보험자들과 동일한 보장을 제공하는 것을 말한다. 이는 피보험자별 위험을 중심으로 심사하고 있는 현재의 국내 단체보험 인수방법에서 발생되는 고객측 불만과 심사의 비효율성을 개선할 수 있는 방안이다. 둘째, 단체별 특성에 따른 보험요율 차등화이다 단체는 산업의 종류, 피보험자의 직무, 지역적 위치, 크기(피보험자수), 성별구성비 등 여러 가지 특성들을 가지고 있으며 이런 특성들은 보장급부에 따라 발생위험에 영향을 미칠 수 있다. 하지만 현재 나이와 성별에 따라서 피보험자별로 정해지는 요율체계만으로는 이런 위험들을 적절하게 반영하지 못하고 단체별 형평성에도 문제가 생긴다. 따라서 정확한 data 구축을 통해 단체 특성별로 어떤 보장에 어느 정도로 위험 발생에 영향을 미치는지를 분석하여 보험요율을 차등부과 할 수 있는 체계를 갖추어야 한다. 셋째, 경험을 활용한 보험료 산정기법이다. 이것은 개인보험과 구분되는 가장 큰 단체보험만의 특성이라 할 수 있는데 해당 단체의 과거 경험 data 즉 청구로 인한 지급금액을 토대로 당해 계약 보험료를 결정하는 방법이다. 이를 위해서는 과거 경험 data가 얼마나 신뢰할 수 있는 지의 정도(신뢰도)를 측정하는 것이 필요하다. 과학적이고 효율적인 단체보험 인수를 위해서 경험율의 활용은 반드시 이루어져야 할 선결과제이다. 넷째, 관련규정의 정비가 필요하다 단체보험의 특성을 갖기 위해서는 가입가능한 피보험자들의 자격규정(eligibility), 활동적근무 조건(actively at work)이 요구되어야 하며 참여비율(가입비율)과 보장수준의 구성방법에 대해서도 가이드라인 설정을 통해 역선택을 최소화 할 수 있는 제도적 보완이 마련되어야 한다. 이런 선진인수기법의 도입과 함께 단체보험 언더라이터의 필요역량을 개발하고 향상시키는 노력도 병행되어야만 종합금융화, 대형화가 진전되면서 대경쟁의 구도로 바뀌고 있는 국내 보험시장에서의 경쟁력 확보가 가능할 것이다.

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Changes on Hospital-based Home Care Services Utilization After Long-term Care Insurance Launch (노인장기요양보험제도 도입 후 의료기관 가정간호 이용실태 변화)

  • Chin, Young Ran;Hong, Worl Lan
    • 한국노년학
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    • v.31 no.2
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    • pp.371-380
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    • 2011
  • This study was to address changes on hospital-based home care utilization after long-term care insurance(LTCI) was launched. National electronic data information(EDI) on hospital-based home care from Health Insurance Review Agency in 2007.7~2008.6(prior to LTCI) and in 2009(posterior to LTCI) was analyzed. After the launch of long-term care insurance, 40 hospital-based home health care agencies(HHCA) were diminished and regions not having any HHCA were increased from 53% to 59%. Hospital-based home care utilization was decreased in the elderly(clients 13.4%, visits 20.9%) as well as non-elderly(clients 3.5%, visits 3.9%). It is presumed that diminished HHCAs result in decreased accessibility to hospital-based home health care for non-elderly. The clients, visits, and reimbursed cost per agency were not changed. It is presumed that small agencies were closed already. The total reimbursed cost per agency in 2009 was 121,850,000 won. Results suggest that the government has to give support to open more HHCA to increase the accessibility for non-elderly. Also, hospital-based home care services utilization has to be monitoring regularly.

Right of disposition of cargo and Air waybill (송하인의 운송물 처분청구권과 항공화물운송장)

  • Nam, Hyun-Sook;Choi, June-Sun
    • The Korean Journal of Air & Space Law and Policy
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    • v.30 no.2
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    • pp.177-199
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    • 2015
  • Commerce enriches human life enriched and within commerce, transportation of cargo is arguably the most important in business transactions. Traditionally, marine transport has been major commercial transaction, but carriage cargo by air is on the increase. While the fare for freight in comparison with that of ocean is higher, air freight has many benefits that justify the higher shipping fee; lower insurance premium, packing charges, inventory control, cost management and especially speed. Therefore, air freight transport is accumulating gradually. An air waybill(AWB) is needed in the air transport flow. It is a nonnegotiable security, so the holder cannot transfer of a right to a third party. Some scholars suggest that a negotiable AWB is needed. However, it seems nearly impossible to do so; an e-AWB use shows a gain in numbers, even if it has not met expectations. Going forward, it would appear reasonable to conduct a follow-up study on the utility and legal problem for e-AWB. After sending goods, the consignor has the right of disposition of cargo in some cases, and more research is necessary, because it is related to change of ownership and a trade settlement. According to WATS (World Airlines Transport Statistics), the Korean Air took third place in international freight in 2014, and fifth in total, domestic and international to great acclaim. However, there is a lack of research supporting the business showing. It is hope that more studies on e-AWB, stoppage in transit, and a risk of outstanding amount, etc. connect to develop Korean air freight industry.

Historical Review for the Government Contractor Defense (Government Contractor Defense(정부계약자항변)에 대한 연혁적 고찰)

  • Shin, Sung-hwan
    • Journal of Advanced Navigation Technology
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    • v.21 no.3
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    • pp.230-242
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    • 2017
  • A significant rise in product-liability cost is expected due to the newly passed product liability amendment Bill approved during the assembly plenary session on March 30, 2017. Korean government legal service(KGLS) filed a damage suit against Korea aerospace industries, Ltd.(KAI) and Hanwha Techwin Co., Ltd., the manufactures of the KUH-1 Surion helicopter crashed. KGLS alleged claims under the product liability Act, the warrant liability Act and the non-performance of contract act. The accountability limits of military aircraft manufacturers was a highly divisive issue among related scholars and legal practitioners. The bottom line was that military aircraft manufacturers had no product-liability insurance available. The United States courts have, therefore, developed the government contractor defense(GCD) and it was recognized by the U.S. Supreme Court in Boyle v. United Technologies corporation(1988). product liability insurances for military aircraft manufacturers are excessively expensive and it cannot be added onto the military procurement cost accounting. However, having an aircraft accident without one can be ruinously expensive. Therefore, the manufacturers should promptly set up appropriate risk management measures. This thesis will first review the advance GCD theory, and then find a way to either reform government contract related regulations.

The Survey Research on Pregnant Woman's recognition about GO-UN-MAM CARD of Childbirth Promotion Policy (출산장려정책 중 고운맘 카드에 대한 산모들의 인식 조사)

  • Kim, Han-Kyoul;Lim, Sung-Won;Lee, Ru-Ree;Park, Soo-Hyun;Go, Dun-Sol;Na, Ha-Neul;Lee, Kyung-Sook;Rhee, Hyun-Sill
    • Journal of Digital Convergence
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    • v.10 no.3
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    • pp.241-250
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    • 2012
  • Low birth rate is a persisting national challenge that causes a decrease in productive population and an increase in encumbrances by ever rising insurance premiums, eventually threatening the existence of the country. This study investigated the effectiveness of the current government's undergoing economic support of the child-birth promotion policy, "go-un-mam card", and suggested improvement plans about the problems derived on the basis of the perceptions of the card users. Multi-response analysis was used to find out the preference of the policy, and chi-square test was conducted to discover the user satisfaction rate and intent of re-parturition. Also, descriptive analysis was performed to identify the degree of the policy recognition. The results illustrated that a significant association exists between the satisfaction rate and the intention of re-parturition. In addition, pregnant women gained information about the policy from governmental agencies and medical institution as well as by word of mouth; then, applied to the policy. Also, the card users only took an advantage of discounts in the hospitals within the supported monetary amounts. Moreover, the card users expressed their dissatisfaction at the monetary amounts. For instance, the users were dissatisfied with the limit on the amount to be used in a day and requested upgrade on the monetary amounts. Based on the result, the government will improve and develop the go-un-mam card for the ultimate purpose of policy, increasing birth-rate.