• Review of KIISC
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• v.23 no.1
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• pp.35-43
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• 2013

국내 시중에는 약 304개 금융회사가 금융 및 보험 상품 서비스를 제공하고 있으며, 최근 금융감독원에서는 국내 304개 금융회사(생 손보 39개사)를 대상으로 한 개인정보수집 이용제공 동의서 운영실태 점검 결과 총 49개 금융회사에서 문제점이 발견되었다. 2012. 2. 17일 개정된 정보통신망 이용촉진 및 정보보호 등에 관한법률에서는 본인 인증확인기관, 법령에서 별도로 수집 이용하는 경우와 방송통신위원회가 고시하는 경우 이외에는 주민등록번호의 사용을 제한하고 있다. 본 연구에서는 국내 개정된 정보보호 관련 법률 관점에서 현 금융회사의 개인정보 활용 및 그에 따른 보안 실태를 연구하고 관련 결과에 따른 법적 IT컴플라이언스를 준수할 수 있는 개인정보 치환 및 관리 방법론 등 관련 법률과 기업의 사회적 책임(CSR)을 만족시킬 수 있는 방안을 제언하고자 한다.

• Journal of Pharmacopuncture
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• v.6 no.1
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• pp.33-34
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• 2003

배경: 독일 의사와 보험회사 위원회 (The German Board of Physicians and Insurance Companies:Bundesausschuss der Arzte und Krankenkassen)가 앞으로 일부 적응증에 대한 침치료에 대해 공적 보험회사가 보험료를 지급해야 할 지에 대한 추가 결정을 하기 위해 침의 효과를 평가하기로 했다. 목적: 1) 침치료가 편두통의 예방, 긴장성 두통, 요통, 무릎과 고관절의 골관절염치료에 대조군 침치료보다 효과가 있는지 검증 2) 침치료가 편두통의 예방적 치료에 표준 약물 치료와 비슷하게 효과가 있는지 검증 3) 보건의료 서비스체계 안에서 주어진 조건에 대한 일상적 침치료의 질적인 부분을 서술하고, 안전성을 평가하며, 다른 침술학파간의 임상결과의 차이와 비용의 효용적 활용부분을 평가한다. 4) 위의 적응증에 해당하는 모든 임상실험연구를 찾아내어 기존의 고찰내용을 갱신한다. 방법: 1) 무작위 표본추출 임상 실험, 침치료, 거짓침 치료, 대기자 명단 대조군, 출발시점 4주, 28주 관찰 2) 무작위 표본추출 임상 실험, 침치료, 표준약물치료 대조군, 츨발시점 4주, 28주 관찰 3) 전향적 다중 의료기관 관찰 연구, 두 가지 다른 자료를 활용하여서, 치료 결과를 침 시술자에 의한 모든 환자 평가 자료와, 열 두 명의 환자 가운데 한 명의 환자로부터 직접 받은 평가 자료 (관찰 출발시점, 치료 출발 시점, 치료 시작 후 6 개월) 실험공간: 1) and 2) 높은 수준의 수련을 한 침 시술 의사가 시술하는 병원이나 일차 진료기관의 외래. 3) 보건 의료 서비스내 저급의 침 시술 의사 (140 시간 수강, 학점 이수 필수) 참가자: 1) $4{\times}320$ 편두통의 예방, 긴장성 두통, 요통, 무릎과 고관절의 골관절염 환자 2) 480 편두통 환자(긴장성 두통 환자 추가적) 3) 약 500,000 환자, 2년 반 동안: 대략 한 적응증 당 10,000 환자 치료법: 모든 침치료 자리는 체침만 허용함. 1) 진짜 침은 학파의 지침에 따른 심자, 거짓 침은 비특이적 자리의 표피만 찌르는 자침 (12-15회, 8주): 대기자 대조군은 12주 동안에 아무 치료도 받지 않는다. 2) Group 1(N=240): 최대 15회 치료, 12주 동안: Group II (N=240) 투약 Proponolol (80-240mg), Metoprolol (100-200mg) or Flunarizin (5-10mg) 하루, 16주 이상 3) 치료회수와 침자리의 선정은 참가자가 결정 주된 임상 결과 지표: 1) 군 간의 치료 전 및 치료 진행 도중 4주 마다의 두통을 느낀 날 수의 차이 (평균 혹은 이상의 편두통이나 긴장성 두통) 2) 요통환자 군간의 기능을 측정하는 FFbH-R (Funktionsfragebogen Hannover) 비교 3) 관절염 환자의 군간 WOMAC 지표 비교 4) 군 간의 24주 동안 두통을 느낀 날 수의 차이(평균 혹은 이상의 편두통이나 긴장성 두통) 5) 적응증, 부작용, 성공율에 대한 거시적 평가, 사용한 침수, 환자의 만족도, SES(?). ADS(?) 통증 장애 지표(PDI), 삶의 질 지표(SF36). 예비 결과 위의 결과가 큰 관찰 연구에 초점을 맞추면서 소개될 것임.

• THE INTERNATIONAL COMMERCE & LAW REVIEW
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• v.67
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• pp.119-142
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• 2015

Many insurers have traditionally incorporated "fraud clauses" into insurance policies, setting out the consequences of making a fraudulent claim. Even in the absence of an express terms, English courts provide insurers with a remedy for a fraudulent claim. However, the law in this area is complex, convoluted and confused. English Law Commission think that the law in this area needs to be reformed for three reasons; (1) the disjunctive between the common law rule and section 17 generates unnecessary disputes and litigation, (2) increasingly, UK commercial law must be justified to an international insurance society, and (3) the rules on fraudulent claims are functioned as a deterrent if they are clear and well-understood. In order for these purposes, English Law Commission recommends a statutory regime to the effect that, when an insured commits fraud in relation to a claim, the insurer should (1) have no liability to pay the fraudulent claim and be able to recover any sums already paid in respect to the claim, and (2) have the option to treat the contract as having been terminated with from the time of the fraudulent act and, if chosen the option, be entitled to refuse all claims arising after the fraud, but (3) remain liable for legitimate losses before the fraudulent act. LC is not recommending a complete restatement of the law on insurance fraud generally. For example, LC does not seek to define fraud, instead, recommends the introduction of targeted provisions to confirm the remedies available to an insurer who discovers a fraud by a policyholder.

• Quality Improvement in Health Care
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• v.4 no.2
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• pp.280-284
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• 1997

Since the start of the Korean Society of Quality Assurance in Health Care in 1994, QA has improved, but it is time to develop our own policies that are more appropriate for Korean hospitals. American Quality Assurance policies are difficult to apply to the Korean medical community due to the differences in health insurance policies, and hospital structure between the two countries. Methods : I would like to propose more efficient organization and management of Quality Assurance according to the specific structures of hospitals in Korea. All of the hospital departments and committees should report to the Quality Assurance office, which in turn should report to the director. I would like to suggest that the current insurance review staff be used for the Quality Assurance office. A nurse should be in charge of the Quality Assurance department. The Quality Assurance department should have three sections: Medical Inssurance Review, QA records for the different Medical Departments, and QA records for the Ancillary Departments. A staff physician should be the chairman of the hospital QA committee, which should serve as the advising body to the QA Department. The QA Committee should be organized into eight subcommittees so that all departments thought the hospital are represented. The current Medical Insurance Review offices in Korea have similar responsibilities to the QA Department: therefore I would like to recommend that the Medical Insurance Review office be changed the the QA office. If there are presently two separate Medical Insurance and QA offices, these should be combined into one office. Conclusion : These changes would surely benefit hospitals and strengthen the efficiency of both Insurance Review and Quality Assurance.

• The Korean Society of Law and Medicine
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• v.22 no.4
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• pp.3-35
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• 2021

Inmitten der Flut der privaten und öffentlichen Information gilt die riesige Informationsmenge als Schlüsselressource im Zeitalter der 4. industriellen Revolution, repräsentiert durch Big-Data. Das Interesse an diesen wächst weltweit. Es gibt eine aktive Diskussion darüber, wie man Daten sichert und akkumuliert und wie man die gesammelten Daten sicher und effektiv nutzt. Gesundheitsdaten werden vor allem als die wertvollste Ressource bewertet, für die Big-DataTechnologie eingesetzt wird. Um Gesundheitsdaten sinnvoll zu nutzen, müssen verteilte Gesundheitsdaten integriert und den Benutzern in einer Form zur Verfügung gestellt werden, die für Forschung oder Inspektion verwendet werden kann. In einer Situation, in der große Länder um den Aufbau bzw. die Führung der Datenwirtschaft konkurrieren, wurden im August 2020 auch in Südkorea die sog. „3-Daten-Gesetze" geändert, die das Datenschutzgesetz(DSG) enthälten. Das DSG führte das Konzept der pseudonymen Informationen ein und baute eine Rechtsgrundlage für deren Verwendung auf. Als Folgemaßnahme kündigte die, Kommission für den Schutz personenbezogener Daten(Personal Information Protection Commission: PIPC)' die „Richtlinien für die Bahandlung mit pseudonymen Informationen" und, Ministerium für Gesundheit und Wohlfahrt' die „Richtlinien für die Verwendung von Gesundheitsdaten" an. Gesundheitsdaten stehen direkt in Zusammenhang mit Leben und Körper des Menschen und damit enthalten viele sensible Daten. Es handelt sich also um ein System, das aus einer vorsichtigeren und konservativeren Sicht unter der Voraussetzung verwendet werden kann, personenbezogene Daten sicherer zu schützen. Um die Hauptinhalte der „Richtlinien für Verwendung von Gesundheitsdaten" zu analysieren, überprüften wir zunächst die Hauptinhalte des überarbeiteten DSG. Danach durch die Analyse der wesentlichen Inhalte der „Richtlinien für Verwendung von Gesundheitsdaten" wurden Probleme wie Konflikte mit anderen Gesetzen und Verbesserungsmaßnahmen überprüft.

• THE INTERNATIONAL COMMERCE & LAW REVIEW
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• v.49
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• pp.257-281
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• 2011

The duty of utmost good faith is found in sections 17-20 of MIA 1906. Critics of the current legal regime on the pre-contractual duty from the viewpoint of the assured, have been concentrated on two points in particular. First, the scope of the duty is so wide that it imposes too high burden on the assured. The second criticism is directed at the remedy, prescribed by the MIA 1906, s.17, against breach of the duty. This article intends to analyse the legal implications of proposals in CP 2007 for reforming pre-contractual duty of utmost good faith of business assured in English insurance contracts law and the problems of proposals. The Law Commissions are proposing four fundamental changes to meet the long-standing criticism and the results of analysis are as following. First, the Law Commissions are proposing a change in the test of constructive knowledge in relation to the duty of disclosure so that a business assured will be obliged to disclose facts which he knows or a reasonable ought to know in the circumstances. Secondly, deviating from the current legal position, the Law Commissions are proposing that if a business assured has made a misrepresentation, but the assured honestly and reasonably believe what it said to be true, the insurer should not have any remedy due to the misrepresentation. The proposal is designed to protect the reasonable expectations of business assured at the pre-contractual stage. Thirdly, the Law Commissions are proposing to change the test for materiality by replacing the "prudent insurer" test by a "reasonable assured" test. The proposed test would focus on the question of what a reasonable assured in the circumstances would think what is relevant to the judgment of the insurer. Finally, the Law Commissions are proposing flexible remedies in case of the breach of the duty. The Law Commissions are proposing no remedy when an assured is acting honestly and reasonably, while avoidance in case of dishonesty. On the other hand, The Law Commissions seem to have an intention to introduce a compensatory remedy in case of negligent breach of the duty.

• The Journal of the Korea Contents Association
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• v.13 no.5
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• pp.234-242
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• 2013

In 2007, Long-Term Care Insurance Law was enacted to share the family burden of caring for the elderly who are unable to perform every day living activities due to their old age and chronic diseases such as senile dementia, diabetes mellitus, stroke and more. Backed by this law, since 2008, care workers have been sent to the elderly care centers or each elder's home to help them not only with their recovery from illnesses, but also with general activities from dressing, eating, bathing, walking even to toileting. However, according to the recently released survey by National Human Rights Commission, it has been found that the caring workers are in a very poor working condition including low income, abused blanket wage system, shortage of welfare services, extra works and even sexual harrassment. It is becoming an important issue due to fast-ageing population, the fact that the care workers have had experiences of violation in their right of labor while they are at work needs to be carefully treated. In that sense, this article presents some difficulties the caring workers face and proposes effective ways to solve these problems through the perspective of human rights and human labor rights based on the report written by National Human Rights Commission. In short, for this law to function properly and to boost the worker's capability of providing better services to beneficiaries, followings can be good answers - enhanced management and supervision on caring plans and care centers, providing immediate counselling and protection for victimized care givers, training courses offered to promote service receiver's sincere respect and strengthened awareness upon care givers.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.4
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• pp.203-210
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• 2018

The UK is famous for being the first country in Europe to adopt the policies of marketisation regarding social welfare. Numerous other countries, including social democratic countries, have followed suit, and South Korea has also adopted the marketisation of care through the introduction of long-term care insurance. The aim of this study is to examine recent reforms concerning adult social care market in the UK, and to determine policy recommendations to further develop the Korean long-term care insurance market. Findings show that the UK has actively regulated and managed the care market. In particular, after the sudden bankruptcy of nursing homes, the CQC systematically analyzes the risks of bankruptcy of big service providers in terms of financial conditions and quality of services according to the six steps detailed in the Care Act 2014. If some service providers experience high levels of risk, the CQC reports results to local authorities in order to manage the risk of bankruptcy of these service providers. Such reforms in the UK suggest a number of policy measures for South Korea in which the problems of long-term care market are prevalent, including increased system management, introduction of a new inspection system, the expansion of public-based inspection organizations, and disclosure of information by the National Health Insurance Corporation.

• Journal of Digital Convergence
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• v.10 no.11
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• pp.493-502
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• 2012

This study aimed to determine the management and environmental factors affecting medical expense reduction. For analysis, medical expenses were divided into hospitalization expenses and outpatient treatment expenses, and the rate of medical expense reduction was classified into initial and final reduction rates. Data were collected through a direct survey among 205 directors of independent health insurance review departments of hospital-level medical institutions in Korea. The results of the study are discussed below: In the analysis, differences in the initial and final reduction rates of hospitalization expenses and outpatient treatment expenses were compared. The results showed that, in hospitalization expenses, the initial and final reduction rates were both significantly affected by the following management factors: number of beds, number of departments, number of personnel reviewing health insurance cases, and total number of employees. Further, in outpatient treatment expenses, the initial and final reduction rates were both affected significantly by the following management factors: management of medical records, number of beds, number of departments, number of personnel reviewing health insurance, and total number of employees. The management factors significantly affecting both the initial and final reduction rates were higher number of beds for hospitalization expenses and electronic medical record management for outpatient treatment expenses. The environmental factors significantly affecting both the initial and final reduction rates of hospitalization expenses were a highly cooperative work environment, better implementation of indicator management systems, and overtime pay. Better implementation of indicator management system and a committee for handling medical expenses had significant effects on the initial reduction rate for outpatient treatment expenses. A highly cooperative work environment, better implementation of indicator management system, and overtime pay had significant effects on the final reduction rate for outpatient treatment expenses.

• Journal of Digital Convergence
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• v.11 no.1
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• pp.13-25
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• 2013

After studying FSMA 24, We found that the insolvency rule of financial institutions in FSMA consists of eight provisions: 1) voluntary arrangement, 2) administration order, 3) receiverships, 4) voluntary winding up, 5) winding up by the court, 6) bankruptcy, 7) provisions against debt avoidance, and 8) supplemental provisions in insurance cases. Insolvency provisions in FSMA explain powers and accountabilities of FSA in relation to these insolvency proceedings. Although there are some differences in proceedings, provisions entitle FSA the same status as creditors to petition the court, with a right to participate in related meetings and to be notified of any matters involving insolvency proceedings. The differences and implications between U.K.'s FSMA and Korean regulations are related to the insolvency rule of financial institutions. First, in FSMA, FSA has a comprehensive power to manage insolvency proceedings of financial institutions in a centralized way. However, Korean regulations have special laws to regulate insolvency in a decentralized way. The offices executing those laws are the Financial Services Committee, the Financial Supervisory Service, and the Financial Deposit Insurance Corporation. This characteristic results from an accelerated legislation procedures related to financial reform in 1997 Korean financial crisis. Second, FSA contains special provisions on continuation of contracts of long-term insurance considering the characteristics of insurance industry related to insolvency of financial institution. However, Korean insolvency rules applied to financial institutions do not consider industrial differences and the characteristics of financial contracts, so need to be supplemented in the future.