• Journal of Convergence for Information Technology
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• v.9 no.9
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• pp.195-200
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• 2019

The purpose of this study is to analyze the characteristics of National Health Insurance claim data and to construct a pilot medical episode data considering it. In this study, the trends of respiratory disease (ICD10: J00-J99) cardiovascular disease (ICD10: I00-I99) from the day of onset of treatment to re-admission after admission were confirmed in Seoul, and the largest decrease was observed when the no-treatment period was 0 day. The data reduction rate when the no-treatment period is 0 day is judged to be due to the monthly separation claim of the health insurance claim data. Also, the result that there is a tendency of monthly separation request according to the type of medical treatment. Through this study, we constructed epidemic data for the pilot medical treatment considering the characteristics of the claim data of health insurance, and based on this, it can be used as a data processing method for calculating basic epidemiological information.

• Journal of Internet of Things and Convergence
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• v.8 no.2
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• pp.13-24
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• 2022

In order to explore the context of fraudulent claims and the measures for preventing them targeting the long-term care institutions for the elderly, which is increasing every year in Korea, this study conducted the text mining analysis using the media report articles. The media report articles were collected from the news big data analysis system called 'BIG KINDS' for about 15 years from July 2008 when the Long-Term Care Insurance for the Elderly took effect, to February 28^th 2022. During this period of time, total 2,627 articles were collected under keywords like 'elderly care+fraudulent claims' and 'long-term care+fraudulent claims', and among them, total 946 articles were selected after excluding overlapped articles. In the results of the text mining analysis in this study, first, the top 10 keywords mentioned in the highest frequency in every section(July 1^st 2008-February 28^th 2022) were shown in the order of long-term care institution for the elderly, fraudulent claims, National Health Insurance Service, Long-Term Care Insurance for the Elderly, long-term care benefits(expenses), elderly care facilities, The Ministry of Health & Welfare, the elderly, report, and reward(payment). Second, in the results of the N-gram analysis, they were shown in the order of long-term care benefits(expenses) and fraudulent claims, fraudulent claims and long-care institution for the elderly, falsehood and fraudulent claims, report and reward(payment), and long-term care institution for the elderly and report. Third, the analysis of TF-IDF was similar to the results of the frequency analysis while the rankings of report, reward(payment), and increase moved up. Based on such results of the analysis above, this study presented the future direction for the prevention of fraudulent claims of long-term care institutions for the elderly.

• Korean Journal of Environment and Ecology
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• v.37 no.6
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• pp.499-507
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• 2023

This study conducted an empirical analysis on a land purchase requisition policy in Bukhansan National Park to draw the efficacy, limitations and implications of this policy. A logistic regression analysis was conducted to identify factors that affected the landowners' decision on applying for land purchase requisition using the government's records on acquisition of private lands in the park since 2006 when this policy began to be implemented. Results illustrate that the probability that a landowner applied for purchase requisition increased if the land was classified as forest, if a large proportion of the land was designated as the nature conservation district, if it was located farther from park boundary, and if it had higher appraised value per square meter. These results indicate that as the landowners had less chance to utilize their lands, they more likely apply for purchase requisition. These results also imply that the government can achieve a high conservation performance level if private lands are acquire by the land acquisition requisition policy. The logistic regression model also predict that 401m² of the private lands in Bukhansan National Park will likely be purchase-requested in future. Despites its usefulness in mitigating landowners' complaints in national parks, the land purchase requisition policy has not been widely utilized. Based on these empirical results, this study provides policy implications to facilitate the ulitization of this policy.

• Patent21
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• s.69
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• pp.18-21
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• 2006

• Journal of the Korean Data and Information Science Society
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• v.24 no.1
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• pp.1-12
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• 2013

In this paper, we introduce a continuous-time risk model where the surplus follows a diffusion process with positive drift while being subject to two types of claims. We assume that the sizes of both types of claims are exponentially distributed and that type I claims occur more frequently, however, their sizes are smaller than type II claims. We obtain the ruin probability that the level of the surplus becomes negative, by establishing an integro-differential equation for the ruin probability. We also obtain the ruin probabilities caused by each type of claim and the probability that the level of the surplus becomes negative naturally due to the diffusion process. Finally, we illustrate a numerical example to compare the impacts of two types of claim on the ruin probability of the surplus with that of the diffusion process in the risk model.

• Journal of Korea Port Economic Association
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• v.30 no.4
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• pp.111-130
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• 2014

The article 742(2) of the Korean Commercial Code allowed the third party to invoke a direct action against the insurer under a liability insurance. Meanwhile, the owners of the vessel enter into the P&I Insurance Contract with the P&I Club to indemnify all kinds of liability or expenses involved in the operation of its vessel. However, the Rule Book under the P&I Insurance mostly included the Pay to be Paid Clause which precludes the third party's direct action. Recently, the Seoul Central District Court passed a judgement on the validity of the Pay to be Paid Clause under the Korean law against the third party i.e. the cargo insurer having the right of subrogation. The court held that (1) the third party's right of direct action is not the right to claim insurance money but the right to claim damages against the P&I Club, (2) the insurer under a liability insurance is deemed to assume liability jointly and severally with the insured against the third party, (3) the Article 742(2) of the Korean Commercial Code is considered as a compulsory provision because it was invented to protect the innocent third party, the Paid to be Paid Clause is thus null and void. The purpose of this article is to evaluate the appropriateness of this court's judgments by comparative analysis of Korean and English law, and to suggest the relevant amendments of the Korean Commercial Code in order to prevent further legal disputes. The article criticizes the decision of the Seoul Central District Court, taking the attitude that, since the third party's right is the right to claim insurance money, the Paid to be Paid Clause is valid against the third party.

• Information Systems Review
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• v.7 no.1
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• pp.275-295
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• 2005

Changes in business environment caused by globalization of the world economy and the beginning of the knowledge society forced hospitals to equip with tools for the enhanced competitiveness. In other words, hospitals must aim three targets such as acquisition of advanced medical skills and equipments, improvement of service level for patients, and achievement of superior managerial performance simultaneously. This study has been done to suggest a way to reduce the possibility of hospital bill claim reduction as an alternative for the achievement of superior managerial performance. If the reduction rate of hospital bill claim is high, it will put negative impact on the hospital's revenue stream and hospital's reliability. Thus, if they want to stay competitive, hospitals need to device ways to cut the reduction rate as much as possible. In this study, a prototype system has been developed and implemented to check the possibility to cut the reduction rate through deep analysis of causes of reduction. The prototype first developed utilizing data mining techniques and the relation rules algorithm. Then the prototype was tested its performance using the D hospital's live data.

• Journal of the Korean Geographical Society
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• v.39 no.3
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• pp.473-493
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• 2004

In Korea, Jeongho Kim is the most noted scholar who studied on a map and a topography during the 19th century. He arranged the merit and the defect of the former maps systematically through such studies and made Cheonggudo(‘do’ means an atlas) in 1834. Accordingly, it reflected the result of many scholars's efforts to make accurate a complete map of Joseon. Especially, it referred to Haedongyeojido which had been made during 1776-1787. Of course, Haedongyeojido also referred to Joseonjido which had been made by Gyeongjun Sin(1712-1781) in 1770. Jeongho Kim did not copy Haedongyeojido as it was but edited it newly.

• Journal of Digital Convergence
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• v.19 no.9
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• pp.317-322
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• 2021

This study focuses on user experience of Ant Insurance Platform(insurance product of Alibaba) and provides insights and improvement advises based on the survey conducted. Given that insurance claim is the most controversial part during the whole process, it is essential to conduct corresponding research from users' prospective. Some Chinese users between their 20's and 40's, who are major users of mobile insurance platforms, were selected as a sample group. Questionaire survey, which was made based on measurement items from Information systems success model, as well as in-depth interview was conducted within the group. According to the result, health, among all kinds, is the most difficult insurance to claim, which was mainly cause by security and information concerns. In order to enhance security, more options should be given to users. As for information, complains should be delt carefully and transparently. This study is expected to be used as referential material for mobile insurance platforms and user experience of insurance claims.

• Journal of the Korea Convergence Society
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• v.13 no.5
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• pp.77-84
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• 2022

The purpose of this study is to provide basic data necessary for preparing a sustainable health insurance system in the future by analyzing the difference in the results of claims according to the claims status of health insurance of dental medical institutions and the level of health insurance knowledge. In this study, a self-written online questionnaire was conducted for dental medical institutions 209 workers from March to May 2019. As a result of the study, The demand for professional manpower according to claim satisfaction was statistically significant in the qualification requirements (p<.05). Therefore, the necessity of professional workers for dental health insurance claims was confirmed and policies for this should be prepared.