• Title/Summary/Keyword: 자가보험

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A Study on Conspired Insurance Fraud Detection Modeling Using Social Network Analysis

  • Kim, Tae-Ho;Lim, Jong-In
    • Journal of the Korea Society of Computer and Information
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    • v.25 no.3
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    • pp.117-127
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    • 2020
  • Recently, proving insurance fraud has become increasingly difficult because it occurs intentionally and secretly via organized and intelligent conspiracy by specialists such as medical personnel, maintenance companies, insurance planners, and insurance subscribers. In the case of car accidents, it is difficult to prove intentions; in particular, an insurance company with no investigation rights has practical limitations in proving the suspicions. This paper aims reveal that the detection of organized and conspired insurance fraud, which had previously been difficult, could be dramatically improved through conspiring insurance fraud detection modeling using social network analysis and visualization of the relation between suspected group entities and by seeking developmental research possibilities of data analysis techniques.

Effect of Capital Market Return On Insurance Coverage : A Financial Economic Approach (투자수익(投資收益)이 보험수요(保險需要)에 미치는 영향(影響)에 관한 이론적(理論的) 고찰(考察))

  • Hong, Soon-Koo
    • The Korean Journal of Financial Management
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    • v.10 no.1
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    • pp.249-280
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    • 1993
  • Recent financial theory views insurance policies as financial instruments that are traded in markets and whose prices reflect the forces of supply and demand. This article analyzes individual's insurance purchasing behavior along with capital market investment activities, which will provide a more realistic look at the tradeoff between insurance and investment in the individual's budget constraint. It is shown that the financial economic concept of insurance cost should reflect the opportunity cost of insurance premium. The author demonstrates the importance of riskless and risky financial assets in reaching an equilibrium insurance premium. In addition, the paper also investigates how the investment income could affect the four established theorems on traditional insurance literature. At the present time in Korea, the price deregulation is being debated as the most important current issue in insurance industry. In view of the results of this paper, insurance companies should recognize investment income in pricing their coverage if insurance prices are deregulated. Otherwise. price competition may force insurance companies to restrict coverage or to leave the market.

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Introduction of InsurTech and Analysis of Re-Entry into Chinese Insurance Market for Korean Insurance Companies (인슈어테크 도입과 한국 보험회사의 중국 보험시장 재진출 전략 분석 연구)

  • Hwang, Ki-Sik;Choi, Sin-Young;Kim, Se-Jin
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.22 no.9
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    • pp.1147-1152
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    • 2018
  • In the recent, Chinese insurance market has taken a introduction of InsurTech. It is a combination of insurance and fintech. This means that the policyholder design their own insurance and take out the policy on-line without insurance planner. This trend is remarkable issue. Growth rate of InsurTech in China have significantly been growing. In addition, Chinese insurance market has kept generally stable and fast growth rate, although Chinese forecasting economic growth is subject to massive uncertainties. Nevertheless, the increase in the number of Korean insurance companies fails to settle into Chinese insurance market due to lack of awareness about newness of Chinese insurance market. Moreover, Korean insurance company in China or planning to enter are not prepared for InsurTech yet. Chinese insurance market is valuable for Korean insurance companies. This paper suggests implications of re-entry into Chinese insurance market to Korean insurance companies by analyzing policies which could make environment to endorse Chinese insurtech and case of Chinese insurtech companies.

The Determinants and Comparison of Health Behavior and Health Service by Private Medical Insurance on National Health-Nutrition Survey (국민건강영양조사 대상자들의 민간의료보험 가입 요인 및 가입여부에 따른 건강행태·의료이용 비교)

  • Lee, Yong-Chul;Im, Bock-Hee;Park, Young-Hee
    • The Journal of the Korea Contents Association
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    • v.10 no.12
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    • pp.190-204
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    • 2010
  • This study firstly examined the socioeconomic and health factors associated with infiltration of private health insurance. Secondly, we compared health behavior, outpatient and inpatient use of private health insured with uninsured. The method of this study is that secondary analysis of the 2008 Korea National Health and Nutrition Survey was conducted for 7178 respondents aged 19 over. We use the logistic regression and t-test for data analysis. The first dependent variable was dichotomy which is divided to private health insured or uninsured and the second dependent variable was the presence and frequency of outpatient and inpatient use. The descriptive variables was gender, age, marital status, income, education, occupation, type of national health insurance, residential area, self confidence of health, prevalence rate of common disease, activity limitation, drinking and smoking status. The result of the major findings are as follows. First, 59 under aged person, married person, people in the higher brackets of income, national employee insured were more likely to infiltrate private health insurance. The poor self confidence of health, activity limitation, person with hypertension or allergic rhinitis and smoker were negatively related in infiltrating private health insurance. Second, private health insured did more preventive behavior such as self-paid health examination, cancer screening, regular exercise than uninsured. Third, private health insured was positively related with the presence of outpatient use and frequency of inpatient use

The convergence study of scaling insurance coverage in socioeconomic, oral health behaviors -Medical consumer (의료 소비자의 사회경제학적 특성, 구강보건행태에 따른 치석제거보험급여화의 융합 연구-의료소비자를 중심으로)

  • Jun, Mee-Jin
    • Journal of the Korea Convergence Society
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    • v.9 no.2
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    • pp.125-136
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    • 2018
  • The purpose of the study is to investigate dental health insurance coverage the awareness and dental health insurance coverage extension to scaling in service consumers. There were significant differences according to education level, age on the appropriateness of the age of yearly scaling benefit, and to married, regions, self-oral health of the frequency of yearly scaling benefit, who their teeth brushed frequence a day on the appropriateness of the fee of yearly scaling benefit. It implies that should be added to the coverage list national health insurance every age group after increasing periodontal disease. It is to be more extension as to age, frequency and fee health insurance coverage of scaling, the effort to improve dental health insurance coverage policy must be continue for oral health in the future.

Effect of Risk Perception of Horticultural Facility Farmers on the Purchase Intention Insurance -Focusing on Jeju island - (원예시설 농가의 위험지각이 보험 구매의도에 미치는 영향 - 제주도를 중심으로 -)

  • Lee, Ho-Seung;Kang, Seung-Eun
    • The Journal of the Korea Contents Association
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    • v.21 no.11
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    • pp.490-502
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    • 2021
  • Horticultural facility farmers subscribe to crop accident insurance and insurance products secured by horticultural facilities in preparation for possible risks in the facility. Insurance is purchased to prepare for natural disasters such as typhoons, hail, frostbite, heavy rain, and strong wind damage covered by the product. In order to find out the effect of risk perception, which is a subjective perception of the risks of a given situation, on horticultural facility farmers' intention to purchase horticultural facility insurance products, the risk perception and insurance purchase intention were analyzed. A t-test was conducted to determine the impact relationship between farm size, insurance coverage, and risk perception, and multiple regression analysis was conducted to verify the effect of personal characteristics and behavioral factors such as subjective perception, reference group, media exposure, and compensation understanding. In addition, a three-step regression analysis by Baron & Kenny was conducted to confirm the mediating role of personal characteristics and behavioral factors in the relationship between risk perception and insurance purchase intention. As a result of the study, although there was no difference in farm size, it was analyzed that policy holders had a higher degree of risk perception than non-subscribers, and that compensation understanding had the greatest influence and subjective knowledge had the smallest influence. In addition, these four factors were verified to have a mediating effect on the relationship between risk perception and insurance purchase intention. These results are expected to provide practical help to the development and marketing activities of horticultural facility insurance products.

A Study of Factors Affecting the Grade Maintenance of Long-Term Care Service Users (노인장기요양보험 이용자의 등급유지 영향요인 분석)

  • Moon, Yongpil;Lee, Hoyong
    • The Journal of the Korea Contents Association
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    • v.18 no.1
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    • pp.76-89
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    • 2018
  • The purpose of this study is to analyze factors affecting a grade maintenance of long-term care service users. Using 2008-2014 long-term care raw data of National Health Insurance Service(NHIS), the predictors were examined through the logistic regression by long-term care beneficiaries of grade. The results showed that there are differences by 3 factor groups and grade groups(1-3 grade). In socio-demographic factors, in the 1, 3 grade, Individuals 64 or younger presented a much higher probabilities of the grade maintenance than those 85 and over. In the 3 grade, people of living alone, resident of rural area presented a much higher probabilities of the grade maintenance than others. In disease factors, In the 1 grade, people with dementia presented a much higher probabilities of the grade maintenance than other 2, 3grades. In the 2 grade, people with stroke, fracture presented a much higher probabilities of the grade maintenance than others. In the 3 grade, people with cancer presented a much higher probabilities of the grade maintenance than others. In service factors, In the 2, 3grade, people having more renewal numbers presented a much higher probabilities of the grade maintenance than others. In the 1 grade, people who use facility benefits for more days presented a much higher probabilities of the grade maintenance than others. In the 2 grade, people who use in-home benefits for more days presented a much higher probabilities of the grade maintenance than others. Based on the finding of study, implications and future research directions were discussed for policy considerations.

A Comparative Study on Seafarers' Industrial Accident Compensation System - Focusing on the German Legislation - (선원재해보상에 관한 비교법적 연구 - 독일의 법제를 중심으로 -)

  • Park, Jun-Mo;Park, Sung-Ho
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.28 no.4
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    • pp.567-576
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    • 2022
  • Seafarers are exposed to various unpredictable maritime risks due to the spatial specificity of the working environment of the sea; thus, sufficient compensation for injured crewmembers is needed. However, Korea does not provide such compensation. Therefore, this study attempted to examine the Maritime Labor Act and the Industrial Accident Insurance Act of Germany, an advanced European social insurance country, and derive implications compared to Korea. First, we investigated how compensations are managed by a public institution in Germany and by shipowners in Korea. Second, regarding the contents of accident compensation, Germany does not only provide continuous treatment and care through various support systems, but also operates various programs to enable a return to ship work. In contrast, Korea has a temporary compensation system that allows shipowners to avoid liability for accident compensation, which is disadvantageous to shipwrecked seafarers. Finally, in Germany, workers' compensation insurance is public, judged considering the origin of work, whereas in Korea, it is determined by shipowners or insurance companies. Therefore, it is necessary to establish a public institution in charge of crew accident compensation to ensure proper compensation for crewmembers in Korea and to improve the Seafarers Act or system to provide compensation for additional medical care, disability pension, and rehabilitation benefits.

An Analysis on Expanding Construction Insurance and Estimating Necessary Budget (건설공사보험 확대 당위성 및 예산소요 분석 연구)

  • Kim, Myeongsoo
    • Korean Journal of Construction Engineering and Management
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    • v.15 no.5
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    • pp.94-102
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    • 2014
  • This study analyzes necessity of expanding construction insurance and estimates required budget. Construction insurance is obliged by National Contract Law and Local Contract Law to protect projet owners and contractors from any unexpected construction risk such as financial losses in construction process. Currently the contracts of design-build and alternate-bid projects as well as PQ project, which are greater than 20 billion won, require the contractors to provide construction insurances in Korea. Insurance premiums are borne by the public project owner. Those contractors whose contract volume is less than 20 billion won burden all risks of projects at their cost. This causes equity problem. Because small-and-medium contractors are discriminated against large contractors since insurance-obliged projects are performed by large contractors and insurance premiums are borne by the public project owner. On the other hands, in all engineering projects, regardless of volume, insurance premiums are borne by the project owner. Therefore current regulation has to be improved, by expanding to all public projects. The average ratio of unobliged projects is 46%, in recent 3 years, prime cost of insurance companies is estimated 0.2%. Moreover considering risks of each construction type, prime cost of unobliged works is estimated as 0.13%. Hence additional necessary budget is estimated to be 2.09 billion won if total volume of public work is 3.5 trillion won. And 2.39 billion won is derived if total volume of public projects is 4 trillion won.

결핵균 등 내성균 천국, 약물 오$\cdot$남용 사회

  • 대한결핵협회
    • 보건세계
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    • v.46 no.8 s.516
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    • pp.28-29
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    • 1999
  • 최근 한국보건사회연구원이 국민의 의약품 사용실태를 조사한 결과에 의하면 1천명중 33명이 매일 항생제를 복용한다. 이는 OECD 회원국가의 평균치 21명보다 월등히 높은 비율로, 약물남용이 우려할 만한 수준임을 보여준다. 이 조사는 또 97년도 의료보험 환자중 병$\cdot$의원에서 58.9$\%$가 항생제를 처방받았다고 밝혔다. 폐렴구균의 70$\~$80$\%$가 항생제 남용으로 페니실린에 내성을 보였는데 이는 아시아 최고수준이다. 약물남용은 항생제 뿐 아니다. 많은 사람들이 의사처방 없이 자가처방으로 약을 구입하며, 자가처방의 절반은 감기약을 구입하는데 이 경우 부적절한 처방이 문제된다. 더구나 감기약은 1가지만으로도 남용할 경우 부작용이 많은데 `판피린과 콘택 600을 주세요` 라는 식으로 물약과 알약을 동시에 주문한다. 이와 같은 약의 중복사용은 약물의 남용효과를 더욱 크게 한다.

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