• Korean Journal of Construction Engineering and Management
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• v.12 no.1
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• pp.13-22
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• 2011

Many studies on cause and prevention of claim have been carried out but they were mostly intended to come up with the improvement measures, improvement system or the measures to deal with the claim, which consequently lacked the substantial ways to identify the details of claim for prevention purpose. That is, there's in fact no tool, in preparation for potential claims, to identify and review the major potential causes at design stage to mitigate the claim and thus, it's necessary to develop the tool such as checklist needed to prepare the claim-supporting documents, check the relevant laws as well as to identify the cause of claim. Hence the study, given the fact that cause of claim is mostly generated at the design stage though the claim itself tends to occur at the construction stage, was aimed at developing the checklist based on contract document such as design documents at design stage for public construction projects in a bid to prevent the potential claim occurred at the design stage.

• Journal of applied mathematics & informatics
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• v.32 no.3_4
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• pp.343-357
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• 2014

In many non-life insurance applications past data are given in a form known as the run-off triangle. Smoothing such data using parametric crisp regression models has long served as the basis of estimating future claim amounts and the reserves set aside to protect the insurer from future losses. In this article a fuzzy counterpart of the Hoerl curve, a well-known claim reserving regression model, is proposed to analyze the past claim data and to determine the reserves. The fuzzy Hoerl curve is more flexible and general than the one considered in the previous fuzzy literature in that it includes a categorical variable with multiple explanatory variables, which requires the development of the fuzzy analysis of covariance, or fuzzy ANCOVA. Using an actual insurance run-off claim data we show that the suggested fuzzy Hoerl curve based on the fuzzy ANCOVA gives reasonable claim reserves without stringent assumptions needed for the traditional regression approach in claim reserving.

• Journal of the Korean Mathematical Society
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• v.50 no.1
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• pp.111-125
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• 2013

In this paper, we consider a continuous time risk model involving two types of dependent claims, namely main claims and by-claims. The by-claim is induced by the main claim and the occurrence of by-claim may be delayed depending on associated main claim amount. Using Rouch$\acute{e}$'s theorem, we first derive the closed-form solution for the Laplace transform of the survival probability in the dependent risk model from an integro-differential equations system. Then, using the Laplace transform, we derive a defective renewal equation satisfied by the survival probability. For the exponential claim sizes, we present the explicit formula for the survival probability. We also illustrate the influence of the model parameters in the dependent risk model on the survival probability by numerical examples.

• Communications for Statistical Applications and Methods
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• v.23 no.1
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• pp.85-91
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• 2016

Aggregate claim amounts with a large claim frequency represent a major concern to automobile insurance companies. In this paper, we show that a new hybrid method to combine the analytical saddlepoint approximation and Monte Carlo simulation can be an efficient computational method. We provide numerical comparisons between the hybrid method and the usual Monte Carlo simulation.

• Journal of Information Management
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• v.31 no.2
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• pp.47-65
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• 2000

KINITI implemented a claim system with EDI. This paper presents the way in which electronic data interchange(EDI) can be used to assist in the management of claim information and describes the definition, structures, benefits, problems of EDI and future enhancement.

• Korea Journal of Hospital Management
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• v.9 no.3
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• pp.71-97
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• 2004

This study conducted a comparative analysis of awareness level of review standards, continuing education, and awareness about the need for speciality and educational courses in order to improve quality of Korean health insurance review work and to present directions for policies of personnel development and continuing education to smoothly perform hospital's insurance claim work and Agency's review work. The analysis unit of the study is individuals, and survey was conducted among hospital's claim officers and Agency' review officers by distributing questionnaires. The major results of the study are as follows: First, it is found that hospital's claim officers and Agency's review officers have conflicting awareness about review standards; more Agency's review officers think that current review standards are universal and reasonable, while more hospital's claim officers believe that they need to be revised. Especially, hospital's claim officers replied that it is possible that review results can differ according to government's policies. Second, there is no significant difference between the two groups in the opinion that there are individual differences in awareness level of review standard. In particular, both groups share the opinion that review results can differ according to officer's interpretation of review standards. Third, Both review officer groups feel the need for further training and continuing education. Fourth, there is no difference between the two groups in the opinion that both groups members should be educated in review related educational institutions. However, while 81.5% of Agency's review officers the education should be offered at the Agency, only 45.2% of hospital's claim officers agreed to it. Fifth, both review personnel do not show any difference in awareness of needed experience to successfully perform review work; both groups replied that three to four years experience is necessary to smoothly perform claim work and review work. This study was tried in order to search for directions to improve Korean insurance review work in quality rather than to explore characteristics themselves of individual factors. In this sense, this study presupposed an intention that the educational subjects for further training and continuing education for the two groups should be the same in order to narrow the awareness gap between hospital's claim officers and Agency's review officers. Thus, this study suggests that it is desirable to offer beginner courses at junior colleges or in undergraduate courses and advanced courses in professional graduate school for six to twelve months. In that a comparison of awareness level of hospital's claim officers and Agency's review officers who are actually in practice should precede appropriate presentation of directions for the qualitative improvement of insurance review work in Korea, the significance of this study lies in comparatively analyzing the awareness level of hospital's claim officers and Agency's review officers and in presenting the establishment of future further training and continuing education.

• Journal of Preventive Medicine and Public Health
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• v.33 no.4
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• pp.393-401
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• 2000

Objectives : To evaluate the impacts of the DRG payment system on the behavior of medical insurance claimants. Specifically, we evaluated the case-mix index, the numbers of diagnosis and procedure codes utilized, and the corresponding rate of diagnosis codes before, during and after implementation of the DRG payment system. Methods : In order to evaluate the case-mix index, the number of diagnosis and procedure codes utilized, we used medical insurance claim data from all medical facilities that participated in the DRG-based Prospective Payment Demonstration Program. This medical insurance claim data consisted of both pre-demonstration program data (fee-for-service, from November, 1998 to January, 1999) and post-demonstration program data (DRG-based Prospective Payment, from February, 1999 to April, 1999). And in order to evaluate the corresponding rate of diagnosis codes utilized, we reviewed 820 medical records from 20 medical institutes that were selected by random sampling methods. Results : The case-mix index rate decreased after the DRG-based Prospective Payment Demonstration Program was introduced. The average numbers of different claim diagnosis codes used decreased (new DRGs from 2.22 to 1.24, and previous DRGs from 1.69 to 1.21), as did the average number of claim procedure codes used (new DRGs from 3.02 to 2.16, and previous DRGs from 2.97 to 2.43). With respect to the time of participation in the program, the change in number of claim procedure codes was significant, but the change in number of claim diagnosis codes was not. The corresponding rate of claim diagnosis codes increased (from 57.5% to 82.6%), as did the exclusion rate of claim diagnosis codes (from 16.5% to 25.1%). Conclusions : After the implementation of the DRG payment system, the corresponding rate of insurance claim codes and the corresponding exclusion rate of claim diagnosis codes both increased, because the inducement system for entering the codes for claim review was changed.

• Fashion & Textile Research Journal
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• v.19 no.2
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• pp.166-179
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• 2017

Fashion industry have been emphasizing on eco-friendly business to enhance their public image. Due to the lack of consumers' awareness and experience of eco fashion advertising, this have resulted in adverse outcomes. Therefore, it is required to develop eco fashion advertisement that meets the public interest of Koreans. This study aims to obtain practical implications which can be applied to further eco fashion advertising. The study examines the public opinion towards eco fashion using Twitter as big data analysis and the protracted implication was provided to consumers as consumer vocabulary to see the advertising effect of consumer vocabulary. In addition, this study focuses on the environmental claim types to identify the most effective advertisement in eco fashion. The results are as follow. Associative claim types had a more positive influence on advertising attitude than substantive claim types. Substantive claim types had a more positive influence on brand cognition than associative claim types. In addition, the moderating effects of consumer vocabulary on advertising attitude and brand cognition were supported in substantive claim types. Advertisement attitude shows positive effects to both brand cognition and brand attitude. It has been proved that brand cognition leads to positive influence towards brand attitude and brand attitude eventually increases consumers' urge to buy products. This study has implication when providing a guideline for eco fashion advertisements.

• THE INTERNATIONAL COMMERCE & LAW REVIEW
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• v.55
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• pp.155-181
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• 2012

This study considered as precautions in light of practical affairs related to a claim for damages focusing on CISG (1980) and PICC (2004). Given summarizing contents of this study, those are as follows. First, when exercising a claim for damages, proving the damages may be difficult and hard. Thus, there is necessity for stating the liquidated damages clause in contract given conclusion of contract. Second, as for the application of interest rate given a claim for interest, CISG is not covered interest rate. PICC is covered interest rate. However, there is possibility that PICC will not be applied as general principles. Thus, to remove this insecurity and uncertainty, there is necessity for stating this in contract by deciding on the detailed standard stipulation after fully discussing about interest payment with the counterpart given sale contract. Third, when a seller delivered non-conformity of the goods for contract, a buyer is desirable to exercise by discreetly judging the exercise method or limitation element on a problem of selecting and exercising remedy favorable to oneself out of a claim for damages and a right to reduce the price. Finally, There was suggestion that the contract parties are desirable to utilize by modifying and supplementing properly this in line with own business-based necessity and situation based on the ICC Model International Sale Contract, and to state CISG and PICC the governing law clause, in preparing contract. This study is expected to possibly become guideline in which the damaged party exercises a claim for damages or aims to cope with the counterpart's exercising a claim for damages.

• Korean Journal of Construction Engineering and Management
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• v.18 no.3
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• pp.22-32
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• 2017

Judging from the past cases, the contractor has frequently suffered losses caused by disapproved requests or reduced payments since it has not known the conditions of the contract or it has filed a claim to the owner without any proper claim system. Therefore, the existing claim process needs to be reformed. In order to reform the claim process, the contractor should consolidate the organizational structure, grant accurate duty assignments to the claims manager, implement regular staff training on how to deal with claims. In addition to this reformation, the contractor needs to improve the management of construction period and process control, and manage related documents thoroughly. Regular meetings are also necessary in claims. This study attempts to prove the effectiveness of the reformed process applied to Project "A", where the owner was responsible for the delayed supply of materials, inaccurate oral instructions, insufficient information on the work, and frequent changes of design. The project was completed in 96 months, which was extended by 34 months from the initial construction period of 62 months. The reformed claim process is expected to be of great help not only to largescale construction works but also to smallscale ones.