• Title/Summary/Keyword: Accident Compensation Insurance

Search Result 120, Processing Time 0.031 seconds

A Study on the Improvement of the Safety Insurance for the Laboratory at the Korean Worker's Compensation Insurance - Focusing on Disability Benefit Pension Type Payment - (산재보험 수준의 연구실안전보험 보장성강화 방안 - 장해보험금 연금형태 지급을 중심으로 -)

  • Song, H.S.;Yee, N.H.;Choi, J.G.;Chun, S.H.;Kim, Jai Jung;Lee, B.H.
    • Journal of the Korean Society of Safety
    • /
    • v.34 no.1
    • /
    • pp.115-121
    • /
    • 2019
  • Background: Due to the diversification and advancement of research, researchers have become to deal with a variety of chemical and biological harmful materials in the laboratories of universities and research institutes and the risk has increased as well. Therefore, it is necessary to strengthen the social safety net for laboratory accidents by strengthening the compensation to the level comparable to that of Korean Workers' Compensation & Welfare Service, when the researchers become physically disabled by laboratory accidents. The purpose of this study is to secure researchers' health rights and to create a research environment where researchers can work with confidence by strengthening the compensation to the level comparable to that of Korean Workers' Compensation & Welfare Service. Method: We analyzed the laboratory accidents by year, injury type, severity of accident and disability grade with the 6 year data from 2011 to 2016, provided by Laboratory Safety Insurance. Based on the analysis result, we predicted the financial impact on Laboratory Safety Insurance if we introduce a compensation annuity by disability grade which is similar to Injury-Disease Compensation Annuity of Korean Workers' Compensation & Welfare Service. Result :As of 2011, the insured number of Laboratory Safety Insurance was approximately 700,000. The Average premium per insured was KRW 3,339 and there were 158 claims. Total claim amount was KRW 130 million, whereas the premium was about KRW 2.3 billion. The loss ratio was very low at 5.75%. If we introduce a compensation annuity by disability grade similar to Injury-Disease Compensation Annuity of Korean Workers' Compensation & Welfare Service, the expected benefit amount for 1 case of disability grade 1 would be KRW 1.6 billion, assuming 2% of interest rate. Given current premium, the loss ratio, the ratio of premium income to claim payment, is expected 41.4% in 2017 and 151.6% in 2026. The increased loss ratio due to the introduce of the compensation annuity by disability grade is estimated to be 11.0% in 2017 and 40.4% in 2026. Conclusion: Currently, laboratories can purchase insurance companies' laboratory safety insurance that meets the standards prescribed by Act on the Establishment of Safe Laboratory Environment. However, if a compensation annuity is introduced, it would be difficult for insurance companies to operate the laboratory safety insurance due to financial losses from a large-scale accident. Therefore, it is desirable that one or designated entities operate laboratory safety insurance. We think that it is more desirable for laboratory safety insurance to be operated by a public entity rather than private entities.

Compensation for Personal Injury and the Insurer's Claim for Indemnity - Focused on the NHIC's Claim for Indemnity - (인신사고로 인한 손해배상과 보험자의 구상권 - 국민건강보험공단의 구상권을 중심으로 -)

  • Noh, Tae Heon
    • The Korean Society of Law and Medicine
    • /
    • v.16 no.2
    • /
    • pp.87-130
    • /
    • 2015
  • In a case in which National Health Insurance Corporation (NHIC) pays medical care expenses to a victim of a traffic accident resulting in injury or death and asks the assailant for compensation of its share in the medical care expenses, as the precedent treats the subrogation of a claim set by National Health Insurance Act the same as that set by Industrial Accident Compensation Insurance Act, it draws the range of its compensation from the range of deduction, according to the principle of deduction after offsetting and acknowledges the compensation of all medical care expenses borne by the NHIC, within the amount of compensation claimed by the victim. However, both the National Health Insurance Act and the Industrial Accident Compensation Insurance Act are laws that regulate social insurance, but medical care expenses in the National Health Insurance Act have a character of 'an underinsurance that fixes the ratio of indemnification,' while insurance benefit on the Industrial Accident Compensation Insurance Act has a character of full insurance, or focuses on helping the insured that suffered an industrial accident lead a life, approximate to that in the past, regardless of the amount of damages according to its character of social insurance. Therefore, there is no reason to treat the subrogation of a claim on the National Health Insurance Act the same as that on the Industrial Accident Compensation Insurance Act. Since the insured loses the right of claim acquired by the insurer by subrogation in return for receiving a receipt, there is no benefit from receiving insurance in the range. Thus, in a suit in which the insured seeks compensation for damages from the assailant, there is no room for the application of the legal principle of offset of profits and losses, and the range of subrogation of a claim or the amount of deduction from compensation should be decided by the contract between the persons directly involved or a related law. Therefore, it is not reasonable that the precedent draws the range of the NHIC's compensation from the principle of deduction after offsetting. To interpret Clause 1, Article 58 of the National Health Insurance Act that sets the range of the NHIC's compensation uniformly and systematically in combination with Clause 2 of the same article that sets the range of exemption, if the compensation is made first, it is reasonable to fix the range of the NHIC's compensation by multiplying the medical care expenses paid by the ratio of the assailant's liability. This is contrasted with the range of the Korea Labor Welfare Corporation's compensation which covers the total amount of the claim of the insured within the insurance benefit paid in the interpretation of Clauses 1 and 2, Article 87 of the Industrial Accident Compensation Insurance Act. In the meantime, there are doubts about why the profit should be deducted from the amount of compensation claimed, though it is enough for the principle of deduction after offsetting that the precedent took as the premise in judging the range of the NHIC's compensation to deduct the profit made by the victim from the amount of damages, so as to achieve the goal of not attributing profit more than the amount of damage to a victim; whether it is reasonable to attribute all the profit made by the victim to the assailant, while the damages suffered by the victim are distributed fairly; and whether there is concrete validity in actual cases. Therefore, the legal principle of the precedent concerning the range of the NHIC's compensation and the legal principle of the precedent following the principle of deduction after offsetting should be reconsidered.

  • PDF

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
    • /
    • v.28 no.4
    • /
    • pp.567-576
    • /
    • 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.

A Study on Reforming the Occupational Health Care System is Korea (산업보건서비스체계의 효율적 관리방안에 관한 연구)

  • 문옥륜;한동운;최병순;최재욱;하은희;이기효;장동민
    • Health Policy and Management
    • /
    • v.4 no.1
    • /
    • pp.138-175
    • /
    • 1994
  • The objectives of this study are (i) to review current situations and problems of the occupational health care system with emphasis on reforming the organizations and services, (ii) to find out a disirable occupational health system model based on integration of the occupational health system and the general health system, and finally, (iii) to suggest policy implications in occupational health services in the light of objectives of the newly emerging national health insurance reform in Korea. The major policy implications of this study are as follows: 1. In the long-run, within the occupational health system, preventive occupational health services such as employees' physical check-up, working environment examination, etc should financially be integrated with industrial accident compensation insurance. Currently separately paying expenses for each different category of services by the owner of an enterprise should be disbursed once through the payment of contributions of industrial accident compensation insurance. And then, it is necessary to strengthen and expand the role and function of industrial accident compensation insurance to cover preventive occupational health services. 2. The occupational health system should be integrated with general health system for its effective management. For the short-term policy, it is necessary to eliminate fiscal and access barrier between industrial accident compensation insurance and national health insurance by means of ex post facto settlement of accounts. The duplication of employees' physical check- ups between under the health insurance program and under the industrial health services must be coordinated in a manner either through mutual authorization by the two parties concerned or through merge into the health insurance. 3. The intent of current employees' physical check-up system focused on detection of occupational diseases, should be converted to an idea of medical surveillance system or biological moritoring system. The introduction of medical surveillance or biological monitoring system is a necessary condition to build a positive, effective and inexpensive occupational health care system.

  • PDF

A Scheme of Compensation System for Farmers' Accidents through the Example of Germany (독일의 사례를 통해 본 농업인재해 보장체계 구축 방안)

  • Min, Byeong-Wook;Kim, Hyo-Chel;Lee, Kyung-Suk
    • Journal of Agricultural Extension & Community Development
    • /
    • v.18 no.3
    • /
    • pp.351-384
    • /
    • 2011
  • The purpose of this study is to look at the case of the German compensation system for farmers' accidents and to build a basic scheme in our country's compensation system for farmers' accidents. When you view examples of Germany, the social insurance scheme for farmers accidents in korea should be design as an independent institution from the existing industrial accident insurance, and it comes to relationships with other social insurance system, preferably with complementary personalities. A general rule of the compensation system applies to all farmers in principle but the coverage limits part-time farmers. Financial burden consists of the mix of insurance premium and state aid. The type and level of benefits is similar to the current industrial accident insurance, which give priority to places on economic security for keeping farmworks, such as cost for using temporary farmers, rather than income loss. In terms of financial system, pay-as-you-go system would be better because of immediate payment with the introduction of the compensation system. The compensation system might be managed and administrated by the existing nationwide organization. Of course, for operating of system review and further research on the technical details such as premium issues and funding problems of government support, the exact classification of the target coverage, premiums based on estimated income for the farmers' estimation, the exact statistical data on the accumulation of agricultural disaster is needed.

A Study on Application of Worker's Compensation Insurance to an Commuting-Time Accident (사업장 출.퇴근 재해의 산재보험적용에 관한 연구)

  • Kim, Byung-Suk
    • Journal of the Korea Safety Management & Science
    • /
    • v.12 no.3
    • /
    • pp.73-79
    • /
    • 2010
  • Currently, in Korea, an accident that takes place during a worker's commuting is generally not considered as work-related accident. However, there are several exceptions such as an accident that occurs in commuting while using transportation provided by an employer, an accident that happens during commuting time that can be regarded as part of a business activity (e.g. tending to work instructed by an employer on the way to or from work), and an accident that is caused by insufficient facility management by an employer. It is even more so as the workers' commuting distance increases with expanding scale of a city, and traffic accident occurs more frequent. Social risk of commuting-time accident is on the rise. Under this circumstance, it is an important social issue to explore how to protect workers from commuting-time accident.

Medical Expenses for Trauma According to the Type of Medical Insurance (외상환자의 보험체계에 따른 진료비 분석)

  • Park, Heeseung;Jung, Yooun Joong;Kim, Young-Hwan;Kim, Tae-Hyun;Km, Min Ae;Kyoung, Kyu Hyouck;Kim, Jung Jae;Hong, Suk-Kyung
    • Journal of Trauma and Injury
    • /
    • v.25 no.4
    • /
    • pp.178-187
    • /
    • 2012
  • Purpose: In Korea, the nation's medical expenses were 12 billion won in 2010. The medical costs for individuals can also be overwhelming. If a patient has sustained severe trauma, his/her insurance company responsible may pay only part of the medical bills. In Korean, there are diverse types of medical insurance, such as health insurance, automobile insurance, and industrial accident compensation insurance. And each insurance system has a different type of payment system. Our study will be essential for establishing the optimal medical expense payment system. Methods: From January to December 2011, we retrospectively reviewed the medical charts of 161 patients who were admitted to our hospital's emergency room after having undergone severe trauma. Of those 161 patients, 125 were retrospectively reviewed. Written permission was obtained from all of the patients. We analysed the demographic characteristics, clinical outcomes, data of the trauma, type of the patient's insurance, and the entire bill when the patient was discharged. Results: Seventy-one patients had health insurance, 48 automobile insurance, and six industrial accident compensation insurance. High-deductible insurance included health insurance and industrial accident compensation insurance, with the deductibles up to 20.6% and 19.1%, respectively. We attempted to analyze the cause of the high deductible rate. In patients with health insurance, medicines, primarily sedatives, pain killers, antibiotics, and fluids. comprised a large proportion. On the other hand, industrial accident compensation insurance deducted for a high-grade hospital room charge. Conclusion: We found that medical expenses were diverse according to the type of insurance. In particular, health insurance forced patients to pay too much of the medical expenses. Therefore, in Korea we should try to identify the insurance problems and improve the wage system.

Current Situation and Reform Scheme for Personal Care Attendants(PCAs) in Workers' Accident Medical Corporation (산재의료원 간병인 관리현황 및 개선방안)

  • Oh, Jin Joo;Lee, Hyun Joo;Choi, Jeong Myung;Kim, Chun Mi
    • Korean Journal of Occupational Health Nursing
    • /
    • v.16 no.2
    • /
    • pp.222-231
    • /
    • 2007
  • Purpose: This study aims to suggest political alternatives for nursing care costs for PCAs to provide qualitative medical benefit for patients with occupational disease by investigating present situation and problems of the nursing care cost system of Korea's Industrial Accident Compensation Insurance. Methods: Data was collected from 6 workers' accident medical corporation and 275 nurses affiliated with Korea labor welfare corporation using self reported questionnaire. Result: Research results were as follows; Character of nursing care cost of the Korea's Industrial accident Compensation Insurance changed as if it aims to support for living expenses for the family; As possible problems which could be caused under current system, administrative problems, decrease of service quality were made as objects of criticism. Some patients did not make every effort in rehabilitation to be beneficiaries continuously. Some patients were supplied with whole one PCA or all-night PCA even though they did not need as much caring as such. Conclusion: The research suggested that PCAs payment system improvement is necessary, and the presented nurses' opinion for the improvement method could be applied for policy making.

  • PDF

Changes and Challenges in the Concept of Industrial Accident Insurance in Korea (산업재해 인정 형태 변화와 보상체계 합리화 연구)

  • Kim, Jin-Soo;Ra, Ji-Hun;Lee, Seong-Young
    • Korean Journal of Social Welfare
    • /
    • v.59 no.3
    • /
    • pp.59-73
    • /
    • 2007
  • The compensation system in industrial accident insurance is systemized with "either receiving all or no benefits at all" according to "admited or denied as an industrial accident". Therefore, they are centered on the decision as "industrial accident" or "non-industrial accident", but judging between the two is very complicated, and has inherent conflicting factors. In the early stage of industrialization, industrial accident compensation was based on the indemnity liability for employer's faults. In order to be compensated any damage, the injured worker should prove that the accident was not due to his or her faults. However it was very difficult for injured worker or his or her family to prove the employer's faults, so it was almost impossible to get compensation. Thereafter industrialization progress and improvement of workers' political status lead to conversion from principle of liability with employer's faults to principle of liability without employer's faults. In addition to that, coverage of industrial accident compensation was also expanded. This improvement strengthened the benefit payment principle of "All or Nothing". Even though the "All or Nothing" principle provokes tremendous criticism, the reason why it's difficult for industrialized countries to adopt partial compensation system, is that partial compensation system worsens the administrative hardship, therefore industrialized countries overcome the restrictions of the "All or Nothing" principle with making balance in provisions for any risk to some extent. However, in Korea because the general compensation system for covering medical cost and income loss from accidents, is not equipped, it could be possible to cause acute conflicts with regard to coverage of industrial accidents. Therefore it is required to improve the industrial accident insurance with the acceptance of the significance and logic of discriminated compensation, and create the integrated compensation system in the long run.

  • PDF

A Study about Circumstances and Perception of Construction Accident Compensation (건설업 재해처리에 대한 환경 및 인식변화 고찰)

  • Hong, Sung-Ho;Choi, Jin-Woo
    • Journal of the Korea Institute of Building Construction
    • /
    • v.10 no.5
    • /
    • pp.69-74
    • /
    • 2010
  • It is the law that injured workers must be paid compensation through occupational health and safety insurance. But sometimes, construction companies cover the compensation for an accident by themselves in order to conceal the fact of an accident. The reason for this concealment is that they wish to get a high mark in PQ. From the point of view of a subcontractor, another reason is to avoid any negative consequences in bids. According to interviewees, some workers, knowing the vulnerability of their employers in this area, demand unreasonable levels of compensation. This study examined the circumstances, influences and participants' perception of accidents on construction sites.