• Title/Summary/Keyword: 보험수가

Search Result 1,312, Processing Time 0.026 seconds

EUS 도입에 따른 언더라이팅 효율극대화 방안

  • Jo, Seok-Hoon
    • The Journal of the Korean life insurance medical association
    • /
    • v.24
    • /
    • pp.79-96
    • /
    • 2005
  • 1. 연구배경과 문제제기 - 보험시장의 환경변화 : 보험업법 개정, 방카슈랑스 도입, 고(高)보장성 생존급부(CI, LTC)상품의 등장, 통신판매 전문보험회사의 설립 허용 - 현행 언더라이팅 시스템의 문제점 : 위험난이도와 판매 채널별 특성이 고려되지 않고 언더라이터에 전건 배정 되어 업무의 효율성이 낮음 - 보험시장의 환경변화에 맞는 EUS(Expert Underwriting System) 도입으로 언더라이팅의 효율성을 증대하고자함 2. 국내/외 생보사 언더라이팅 시스템 현황 비교 및 개선방안 - 국내 언더라이팅 시스템 현황 : 청약서 입력/스캔 후 진단 및 적부 유무(有無)에 따라 자동으로 언더라이터에게 심사가 배정됨 - 미국 언더라이팅 시스템 현황 : EUS에 의한 1차 전산승낙여부 결정 후(後)언더라이터에게 심사가 배정됨 - 위험난이도의 고저(高低)와 관계없이 언더라이터에 배정되는 심사시스템의 문제점을 극복하고 체계적인 위험평가를 위해 EUS도입이 필요함 3. EUS 선행요건 - 고객정보의 확보 - 국내 생보사의 고객정보 수집원 : 청약서, 모집인 보고서, 건강진단서,적부조사, 보험사고정보조회시스템 (ICPS), 고액보험 및 상해보험 중복가입자에 대한 정보 교환제도 - 북미 생보사의 고객정보 수집원 : 청약서, 모집인 보고서, 의사소견서 및 진료기록서, 건강검진, 적부조사, 정보교환제도( 북미보험사간 의료정보 공유-MIB) - 정확한 고객정보의 확보방안 : 법률/제도의 정비, 청약서 질문 내용의 세분화, 의료정보교환제도의 구축 4. EUS 개요 및 현황 - EUS의 정의: 고객의 정보를 입력하여 청약부터 보험증권 발행 단계까지 One-Stop 서비스를 제공하는 것으로 언더라이터가 청약서를 가지고 언더라이팅 하는 것과 동일한 업무를 할 수 있는 전문가 시스템 - EUS의 장점: (1) 비용절감 및 인력의 효율적 활용 (2) 업무별 시스템화 되는 조직속성에 적합함. (3) 언더라이팅 정책이 경영 환경 변화에 대처하는데 신속함 - 국외 EUS 현황 (예: Cologne Re) 및 사례연구 5. 위험분류 및 EUS 개요현황 (언더라이팅 시스템 도입) - 위험관리 선행요건으로 위험요소별 분류가 체계적으로 수립되어야 함. - 데이터웨어하우스 (의사결정을 목적으로 설계된 조회와 분석이 가능한 통합된 정보저장소) 시스템 사용 - EUS 도입을 통한 언더라이팅 프로세스: 데이터마이닝 과정을 통해 "자동승낙, 언더라이터에게 심사배정, 적부의뢰, 진단의뢰, 텔레 언더라이터, 보완지시"등이 결정됨. 6. 판매채널별 EUS 활용방안 - 대면채널: 효용성 높은 정보제공과 정확한 위험분석이 가능한 시스템으로 고(高)보장, 고(高)위험 상품에 대해 언더라이터가 집중 심사 할 수 있게 함. - 방카슈랑스: 3S(간결, 신속, 서비스)의 특성에 맞는 전과정 무인자동심사시스템 - 비대면채널: 판매상품과 타겟시장을 명확히 한 후 도덕적 위험과 재무적 위험에 대한 평가시스템 및 의사결정 시스템을 도입 7. 결론 - EUS 도입의 기대효과 (1) 심사기일의 단축으로 고객만족 실현 (2) 체계적 과학적 리스크 관리로 위험률차익 증대에 기여 (3) 업무효율의 증대와 언더라이터의 역량강화 (4) CRM 활용증대와 모바일 청약시스템 구축의 근간 - EUS 도입시 경제적 법률적 제도적 문제 극복과 생보 업계 공동의 관심과 노력이 필요함 - EUS를 활용하여 종합적.체계적 리스크 관리가 가능한 금융회사로의 경쟁력 향상에 기여함.

  • PDF

The Care Giving Burden of Primary Caregiver based on Nursing Needs of Long-term Care lnsurance Grade (노인 장기 요양 보험 등급자의 간호요구에 따른 주 수발자의 부양부담감)

  • Kim, Mi-Kyoung;Park, Dahye;Ahn, Okhee
    • Journal of the Korea Convergence Society
    • /
    • v.5 no.3
    • /
    • pp.7-16
    • /
    • 2014
  • The purpose of this study was to identify the factors influencing the level of nursing needs of a long-term care service user at home and the care giving burden of a primary caregiver. For this study, data were collected from 152 primary caregivers in J City with self-administered questionnaires and analyzed using multiple regression technique. Among the nursing needs of long-term care giving service users, the level of psychological and social requests was the highest. This study found that two characteristics variables(long-term care insurance benefit level and long-term care giving grade) had difference was statistically significant in physical nursing needs and psychological nursing needs. Out of care giving burden of primary caregivers, physical care giving burden was found to be the highest. Out of factors influencing care giving burden, daily care giving hours was the factor which had strongest influence. Basic living recipients and female primary caregivers showed higher care giving burden. The more care givers there were, the less care giving burden became.

Measuring Efficiency and Productivity Change of the Korean Life Insurance Industry (우리나라 생명보험 산업의 효율성 및 생산성변화 분석)

  • Hong, Bong-Young
    • The Korean Journal of Financial Management
    • /
    • v.20 no.2
    • /
    • pp.263-291
    • /
    • 2003
  • The purpose of this paper is to analyse the change in the productivity of Korean life insurance industry by Generalized Malmquist productivity indices. Generalized Malmquist indices will be decomposed into three components such as pure efficiency change, scale efficiency change, and technical change. The principal findings indicate an overall increase in productivity driven more by technical progress than pure technical efficiency and scale efficiency.

  • PDF

Perception toward long-term care insurance system among seniors in health and welfare colleges (보건복지계열 예비졸업생의 노인장기요양보험에 대한 인식 조사)

  • Hwang, Rah-ll
    • Journal of the Korea Convergence Society
    • /
    • v.8 no.11
    • /
    • pp.193-201
    • /
    • 2017
  • The purpose of this study was to be identified the perception toward long-term care insurance system among seniors in health and welfare colleges. The questionnaire was distributed to 207 students in a local area. Data were analyzed by SPSS 22.0ver. The subjects' interest and knowledge level an long-term care insurance system was low, but the attitude was positive. Knowledge levels and attitudes related to lang - term care insurance system were found to differ according to elderly institutional service experience. In conclusion, it will be necessary to develop curriculum and active program of volunteer activities to improve the awareness and interest of lang-term care insurance system in health and welfare colleges.

A Development of Cross-Sell Scoring Model (교차판매(CROSS-SELL) 스코어링 모형 개발)

  • 한상태;강현철;이성건;정요천
    • The Korean Journal of Applied Statistics
    • /
    • v.17 no.2
    • /
    • pp.229-238
    • /
    • 2004
  • Cross-sell models are used to predict the probability or value of a current customer buying a different product or service from the same company. Selling to current customers is one of the easiest way to increase profits and allows companies to carefully manage offers to avoid over-soliciting and possibly alienating their customers. In this study, by using the real database of an insurance company in Korea, we try to explain the steps of actual data mining process. Especially, this study aims to develop cross-sell models to predict the probability which a current customer of automobile insurance buys long-term insurance product.

A Study on Way to Classify Premium Rate Considering Flood Risk (홍수위험도를 고려한 보험요율 차등화 방안)

  • Sim, Gyu-Seong
    • Journal of the Korea Academia-Industrial cooperation Society
    • /
    • v.16 no.4
    • /
    • pp.2933-2939
    • /
    • 2015
  • Premium rate should be applied the insurance objects are classified reasonably, depending on the degree of exposure to disaster risk. But the existing premium rate is applied same basic rate each cities and districts without the degree of exposure to disaster risk. In this study, we analyzed the exposure to flood risk using channel buffering and suggested way to classify the premium rate by reflecting the analysis results in order to improve its. It is determined that this study would contribute to calculate the storm and flood insurance basic rate reflected risk and make and analysis of flood risk of the local river that conditions of inundation simulation is insufficient.

Library Risk Management and Insurance (도서관 리스크관리와 보험)

  • Chung, Hye-Kyoung
    • Journal of Information Management
    • /
    • v.31 no.4
    • /
    • pp.1-12
    • /
    • 2000
  • The potential risks, involved with the management of a library, may cause a tremendous economic loss, so require a systematic management. The rist management process, consisting of risk identification, risk measurement selection of risk treatment methods, implementation, and monitoring and evaluation, suggests the use of insurance to deal with property risks, liability risks and personnel risks. For the systematic risk management of a library, risk manager should be appointed to be responsible for program development and insurance purchase. The limited coverage of library risks, provided by the school cooperative society, should be supplemented through development of insurance products. Further study is required to improve the library risk management and the application of insurance in a systematic and realistic way.

  • PDF

불과 민속 - 불을 신성시하고 숭배하는 종교, 조로아스터교

  • Jo, Seung-Yeon
    • 방재와보험
    • /
    • s.121
    • /
    • pp.60-65
    • /
    • 2007
  • 인류의 종교사에서 커다란 사건 가운데 하나를 꼽으라면 아마 조로아스터교의 출현을 들 수 있을 것이다. 고대 아시아에서 배화교라고도 알려진 이 종교는 종교사 만큼이나 세계사의 흐름을 바꿔 놓는 데도 큰 역할을 했다. 우선 조로아스터교의 등장은 진정한 세계 제국이 등장할 수 있는 토대가 되었다. 그 이전의 모든 종교는 민족 종교의 성격이 강했다. 그래서 어느 민족이 패권을 잡게 되면 피지배 민족의 신은 철저하게 배척당하거나 파괴되었다. 성경을 접해본 사람이라면 구약의 이스라엘 민족이 정복한 민족과 그들의 신을 얼마나 철저하게 파괴하는지를 알 수 있다. 그러나 조로아스터교의 경우는 다른 종교들과는 조금 달랐다.

  • PDF

A Study on the Insurance Contribution and Health Care Utilization of the Regional Medical Insurance Scheme (1개 군지역 의료보험제도에서의 보험료 부담수준별 병.의원 의료이용에 관한 연구)

  • Lee, Sang-Il;Choi, Hyun-Rim;Ahn, Hyeong-Sik;Kim, Yong-Ik;Shin, Young-Soo
    • Journal of Preventive Medicine and Public Health
    • /
    • v.22 no.4 s.28
    • /
    • pp.578-590
    • /
    • 1989
  • This study was conducted to assess the equity in the regional insurance scheme through analysis of the computerized data from one regional insurance society and National Federation of Medical Insurance. We analysed the insurance contribution and benefit by the classes based on total and income-related contribution per household. The major findings of this study are as follows : 1. The average proportion of income-related contribution among the total was 39.2% and the upper classes show higher proportion of the income-related contribution. 2. The upper classes show higher health care utilization rate than the lower classes. It suggests that the lower classes have relatively large unmet medical needs. 3. The analysis through the Lorenz curve reveals that there exists transference of contributions from the upper to lower classes. But the cumulative percentage of insurance benefit is smaller than that of the number of the insured. It implies that regional medical insurance scheme in Korea has still some inequity in the context of social security principles.

  • PDF

A Study on the Problems and Development of the Benefits in Work Injury Insurance (산재보험 급여체계의 합리화 방안에 관한 연구)

  • Kim, Jin-Soo
    • Korean Journal of Social Welfare
    • /
    • v.37
    • /
    • pp.119-141
    • /
    • 1999
  • Korea paid attention to the work injury insurance in the early economic development stage as other developed countries did. Thus "The industrial Accident Compensation Insurance Law" was legislated in 1963 and it is now expanded to apply to the workplace with five or more employees. Beside the low coverage of the number of employees, the scope of benefits are the problem of work injury insurance. The work injury insurance's main benefits are for the loss of income and the medical cost caused by occupational accidents. On the other hand, the investment on the prevention accident and the medical, social and employment rehabilitation is very low, even though the occupational accident pension is higher than that in other OECD countries. Practically lay-off benefits and survivor' benefit for some special workers are paid more than they need, therefore they want to remain under the benefit condition and the medical care days are longer. This paper indicates the problems of work injury insurance and suggest how to improve the functions of it.

  • PDF