• Title/Summary/Keyword: 보험중재

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A Study on No-Fault Arbitration in U.S.'s Automobile Insurance - Focus on the Case of New York State - (미국 자동차보험에 있어서 무과실보험의 중재에 관한 고찰 - 미국 뉴욕주를 중심으로 -)

  • Kim, Ji-Ho
    • Journal of Arbitration Studies
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    • v.22 no.1
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    • pp.89-110
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    • 2012
  • No-fault automobile insurance system is a statutory scheme to provide automobile accident victims with compensation for certain expenses arising from personal injuries occurring in car accidents. New York State has enacted No-Fault Law to ensure that the injured in automobile accidents be paid rapidly by their own insurance company for medical expenses, lost earnings regardless of fault, replacing common law system of reparation for personal injuries under tort law. Its primary purpose is to facilitate compensation without the need to exhaust time-consuming litigation over establishing the existence of fault and the extent of damages. No-Fault Law allows arbitration as a method for settling the no-fault insurance disputes. No-fault arbitration, however, differs in a significant way from general arbitration system. First, No-Fault Law provides the parties with the option to submit any dispute involving no-fault automobile insurance to arbitration. Second, no-fault arbitration attempts to speed its procedure incorporating various methods. Third, the parties are required to seek review of arbitral awards by master arbitrator prior to seeking court's review. Fourth, the parties have right to bring de novo action in court if master arbitrator's award exceeds $5,000. Given the current state of law in Korea, it may not be easy to introduce no-fault arbitration system into Korea in the context of automobile insurance disputes settlement as its law has a long-established reparation system based on tort liability and no-fault arbitration system has its own features that differ from general arbitration system. Nonetheless, it could be suggested that no-fault arbitration be introduced in other fields which require speedy dispute resolution and a third party's decision to settle the disputes. The optional right of submitting disputes to arbitration as provided by No-Fault Law of New York State may offer a ground to supprot the effectiveness of an optional arbitration agreement.

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An Increase the South-North Economic Corporations and Insurance as a Scheme for the Transfer of Risk - Focus on the Source of North Korea Insurance Law - (남북경협증가에 따른 위험의 완화방법으로서의 보험제도 - 북한보험법의 법원문제를 중심으로 -)

  • Kim Sun-Jeong
    • Journal of Arbitration Studies
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    • v.15 no.3
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    • pp.267-301
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    • 2005
  • Following the increased economic corporations between the South and North Korea, many companies participate the corporation program. They needs insurance policy as a scheme for the transfer of risk from those individual company to it to an insurer. This paper review the possibility of the North Korea insurance authorities and research the origin, history, structure and context of the North Korea insurance law. The North Korea Insurance law differ from the South Korea and China's. North Korea Insurance authority has not capability of doing insurance business both side of underwriting and indemnity. Partly, it caused the uncertainty, insufficient and vague of the insurance law. The writer conclude that the North Korea insurance law faced to the needs of modernization. Especially, the Gyesung Industrial Complex Insurance Regulation couldn't cover the investor and company's risk because it is not based on the nature and basic principles of insurance.

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A Study on the Task and Role of Arbitration in Korea by Discussions on the Allowance of Insurer to Invite Overseas Patients (우리나라 보험사 해외환자 유치 허용 논의에 따른 중재의 역할과 과제)

  • Kim, Kee-Hong;Byeon, Seung-Hyeok
    • Journal of Arbitration Studies
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    • v.29 no.2
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    • pp.225-237
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    • 2019
  • Recently, it has been argued that it is necessary to attract foreign patients outside domestic insurers and to allow foreign doctors to treat in domestic hospitals in order to develop the insurance industry and revitalize the medical industry. Currently, large medical institutions in Korea are attracting foreign patients in connection with foreign insurance companies. It is desirable to increase the number of overseas patients who want excellent medical services in Korea, and to provide opportunities for domestic insurance companies to attract overseas patients by expanding job creation through a revitalization of the medical industry. Therefore, this study suggests the development direction for insurers who aim to attract foreign patients through the side effects of attracting foreign patients in accordance with the Financial Services Commission's plan to strengthen the competitiveness of the financial industry. In addition, this study intends to contribute to the strengthening of the competitiveness of attracting foreign patients, through domestic insurance business, to the insurance direct payment market for overseas patients using domestic medical institutions that are concentrated in foreign insurance companies and in the blind spot of domestic law application.

A Study on the Risks Excluded of Marine Insurance Claims (해상보험 클레임의 면책위험에 관한 고찰)

  • Jung Sung-Hoon;Choi Hyuk-Jun
    • Journal of Arbitration Studies
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    • v.15 no.2
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    • pp.125-162
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    • 2005
  • This paper examined excluded risks of insurer in marine insurance generally, and found out the existing studies on the excluded risks, which were accomplished partially and fragmentarily, to conduct a comparative analysis of marine insurance based on the general flow of claim adjustment. It arranges the existing studies to settle a dispute between the parties -insurer and assurer- and studies the excluded risk based on risk change of the insured by analyzing characteristic and class of security violation, and meaning, form, effect of risk change. it inquires into and analysis cases of the Korean Supreme Court related to the exclusion and illegal act of marine insurance to compare marine theorists' opinion with commercial law.

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A Study on the Mediation and Arbitration of Traffic Accident Disputes (자동차교통사고 분쟁의 조정과 중재에 관한 연구)

  • Nam, Seon-Mo
    • Journal of Arbitration Studies
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    • v.24 no.2
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    • pp.81-107
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    • 2014
  • ADR has recently been expanded, making it possible to solve traffic accident disputes, which is a matter of urgency for parties to avoid. This point serves as an important procedural element. Such disputes are an area that requires a quick resolution. To try to solve any dispute that occurs in the complex environment of modern times one-by-one through litigation does not make sense. It gives an undue burden on the judicial body and the investigation agency. Like litigation, today's arbitration system, should have effective conflict resolution. The arbitration of automobile traffic accident disputes can be seen as roughly adjusted through the insurance company, the Dispute Coordinating Committee, and the Crime Victims Protection Act. It consists of experts mainly, and the resolution of automobile traffic accident disputes can be resolved through the Sajonsa and workers insurance company. However, adjustments to failure incident mostly need attention. Most of a company's compensation insurance indemnity needs to be processed in practice. In addition, a vicious cycle of litigation and delay period is repeated if a lawyer is appointed. There are unreasonable adjustment systems in the midst of these. Avoiding traffic accidents allows parties to resolve disputes better. Arbitration of disputes in automobile traffic accidents handled by arbitration institutions is desirable. It is determined that the handling of a case by a village attorney is efficient.

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A Study on the Introduction of Liability Compensation Insurance to Prevent Medical Dispute (의료분쟁 예방을 위한 책임보상보험 도입에 관한 연구)

  • Kim, Kee-Hong
    • Journal of Arbitration Studies
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    • v.28 no.4
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    • pp.43-59
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    • 2018
  • This study aims to review various efforts required by medical institutions to prevent medical accidents in advance and to suggest the necessity of introducing liability insurance for medical accidents based on cases abroad and compulsory professional indemnity insurance at home. Over the past five years between 2013 and 2017, the number of inquiries regarding medical accidents and medical disputes has increased by 11.1 percent from 36,099 to 54,929, and the number of mediation and arbitration for medical disputes has increased by 14.3 percent from 1,304 to 2,225. Since some medical accidents even cause social problems, a compulsory insurance system for the liability of medical institutions for damages need to be introduced to promptly compensate the victims of medical accidents and to ensure compensation by medical personnel. In Korea, a system is in place to provide compensation for a client who suffers an accidental damage after receiving professional services, regardless of whether or not the professional service provider can provide compensation. In major foreign countries, a medical liability system is in place that is applied either by the principle of liability with fault, or the principle of liability without fault. In this study, the cases of compulsory insurance and semi-compulsory insurance in the US and Japan to which the principle of liability with fault is applied, as well as the case of New Zealand to which the principle of liability without fault is applied, were examined. It is necessary to urgently introduce the compulsory insurance system for the liability of compensation to prevent medical disputes and to compensate for the life and physical damages of the victims of medical accidents in domestic medical institutions. Doing so is expected to ensure fair compensation for the victims of medical malpractice and compensation by medical personnel, thereby improving medical practice.

A Study of Awareness and Implementation of OBP(Occupation-Based Practice) (작업기반 중재(Occupation-Based Practice)에 대한 인식 및 실행 조사연구)

  • Chang, ki-yeon
    • The Journal of Korean society of community based occupational therapy
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    • v.7 no.2
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    • pp.19-31
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    • 2017
  • Objective : This study was to learn the Korean Occupational Therapists' awareness and current state of implement of Occupation-Based Practice and to use it as a baseline data. Methods : After 300 Korean clinical occupational therapists were conveniently sampled, the structured 293 questionnaires were released, the answered 293 questionnaires were analyzed. Results : Awareness of OBP was 5.7 points on average and the awareness, increased with age and clinical experience. The opportunity that Occupational Therapists know OBP was through major subjects, articles & seminars, through peers and so on. The differences depended on age, level of education, location of work, clinical experience. 152 Occupational therapists(52.8%) answered that they apply OBP in their clinical work. There was no significant difference in the use of OBP based on gender, age, clinical experience, education background with exception of work location. It was shown that during practice,The most frequently used OBP was as follow in order: interview, practice, goal setting, assessment and documentation. The goal of using OBP was to find out a meaningful occupation for client's living, to promote client's participation in family or community, to treat for function recovery of clients. The biggest difficulty faced during OBP was lack of understanding of OBP for the clients and their guardian. Other difficulties were limitations of treatment environment, lack of occupational instruments, related knowledge, utilization method, preparation time and difficulty in handling insurance and medical expenses in order. Conclusion : Level of awareness of OBP was at intermediate level and it was related to education level and treatment environment. Based on this result, it is need to support institutional and academical discusstion in order to promote OBP.

Effects of Case Management Program on Glycemic Control among Patients with Diabetes (국민건강보험공단 사례관리 사업이 당뇨병 환자의 혈당 조절에 미치는 효과)

  • Song, Young-Su;Bae, Nam-Kyou;Cho, Young-Chae
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.11 no.4
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    • pp.1520-1527
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    • 2010
  • The purpose of this study was to confirm the effect by case management and durability of the effect, which targeted on the 115(51 men and 64 women) people who had undergone diabetes case management through the National Health Insurance Corporation from May 1. 2007 to June 30. 2007. In order to evaluate the effect of case management and durability, the study was examined just before the case management, right after case management, after 6 months and after 12 months through classifying case management 1(Group I) and case management 2(Group II). As a result, the participants' blood glucose level in the diabetes case management improved just after the case management compare to just before one. but it had a tendency to increase once more after 6 months and 12 months case management. In addition, it was confirmed to maintain the effect by the case management in Group II compare to Group I.

Analysis of the Nursing Interventions Performed in the Medical & Surgical Units and the Health Insurance Cost Items Based on the NIC (간호중재분류체계(NIC)에 근거한 내${\cdot}$외과계 간호단위의 간호중재 수행 및 건강보험 수가 항목 분석)

  • Park, Ok-Yeob;Jung, Myun-Sook
    • Journal of Korean Academy of Nursing Administration
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    • v.11 no.4
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    • pp.449-467
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    • 2005
  • Purpose: This study aims to offer the fundamental data in order to cost the nursing service on the basis of the NIC and a close examination of the interventions that are contained in the health insurance cost list under the system of the current health insurance. Methods: The data is handled with the SPSS 10.0 program. The participants' general peculiarity is calculated in terms of the real number and the percentage, and the performing frequency of the nursing interventions is calculated in terms of the mean and the standard deviation. the correlation between the participants' general peculiarity and the performing frequency of the nursing interventions is analysed with t-test or one way ANOVA of SPSS. Results: In the performing frequency of the nursing interventions, the domain of "the physiological: basic" was the highest as 2.69${\pm}$1.21, the domain of "the behavioral" was the lowest as 2.11${\pm}$1.12. There were 50 core interventions in the medical unit, 48 in the surgical unit, 24 in the MICU and 33 in the SICU. The health insurance cost items contained commonly in the core interventions of each unit were 12, and the health insurance cost items except 12 items contained commonly in the core interventions of each unit were appeared 14 items in the medical unit, 6 in the surgical unit, 7 in the MICU and 2 in the SICU. The core interventions contained commonly in four units of the medical unit, the surgical unit, the MICU & the SICU are 18. And among these, the core interventions contained in the health insurance cost items are 10; pain management, hyperglycemia management, analgegic administration, medication administration: intravenous, oxygen therapy, pressure ulcer prevention, fluid management, fluide monitoring, intravenous(IV) insertion, intravenous(IV) therapy. As the result of the comparison & analysis between the core interventions of the NIC and the health insurance cost items, the core interventions contained in the health insurance cost list are 21(29 as the health insurance cost items). Conclusion: In the performing frequency of the nursing interventions, the domain of "the physiological: basic" is being performed most frequently, and in the performing frequency of the core interventions, the interventions of the domain of "the physiological: complex" is being performed most frequently. On the basis of these results, the writer hopes that the attempts to interlink the nursing interventions into the nursing cost by using of standard terms and the efforts to cost the nursing services would also be made in the future constantly.

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