Objectives : The recognition rate for issues and improving resolution for the recuperation income expense claim policy was examined. Methods : 1,135 copies of survey have been sent to the group of people who have claimed the dental recuperation income expense to dental recuperation institutions in Daejeon, Chungcheong Do that are registered to the health insurance evaluation and estimation office as of the May 2010 and 207 surveys that were regarded to be sincere for answering were analyzed. Results : Majority of respondence were belonged to the dentist institutions with more than 5 years of claim experiences as well as 10~50% of claim rate. The recognition of medical fee evaluation guideline was normal level, and negative recognition was higher to the health center with daily charge policy compare to the dental hospital and university affiliated dental center with treatment charge policy, Highest opinion for inappropriateness of dentist with significance was found (p<0.05). The openness of evaluation cases are regarded to be discharged through the transparent evaluation and most of the opinions for insurance claim evaluation adjustment are within the both 'Do not understand the evaluation guideline and program error of disease category, code and program' with significance(p<0.05). The reaction after the evaluation adjustment was high in reflection on the claim process after examining the reason for the evaluation adjustment through the evaluation and estimation office and university affiliated dental institution and dental center was regarded to be most active and deputy reclaimment was seemed to be most actively discharge the objection registration task (p<0.05). The claim error improving resolution recognition was highly prioritized to the accurate charting for the disease title and treatment description, improving the setting of claim program, and most highly recognized by the university affiliated dental hospital/dental center and comparably low by health center(p<0.05). and although the most of the responds of treatment description and browsing the medical fee was positive, 50% of dentists disagreed the idea so that this was creating a significant discrepancy with other groups(p<0.05). Conclusions : From this research, the recognition of medical fee evaluation guideline for dental (university) hospital and dentists were negative and high adjustment experience was examined as lacking of evaluation guideline understanding and error of disease name, code and programs and deputy reclaimment, university affiliated dental hospital/dental center were most actively handle the objection registration tasks and dentists have objection on the treatment description and browsing the treatment fee so that if these indexes can be referred to implement into the recuperation income claim process, this can be regarded to be a opportunity to create mutual credibility between recuperation institution, treatment pensioner and the evaluation institutions.
In investigating how set-off defenses matter in arbitration, one should take into account that it is not permitted against the parties' will for arbitrators to rule on the disputes that are not the subject of an arbitration agreement, unless otherwise agreed upon by the parties involved, because it is considered that the parties intend to solve only the disputes which are the subject of the agreement by arbitration. Also, one should keep in mind that the parties must settle the disputes that are the subject of an arbitration agreement by arbitration when they conclude the agreement, and it is not allowed against the parties' will to resolve the disputes in other ways. The parties may agree whether the respondent can request for arbitration on the counterclaim, which is his/her claim against the claimant, and whether the respondent can raise a plea for a set-off that his/her claim against the claimant is a counter obligation. Failing on such agreement, the respondent may submit a counterclaim when his/her claim and the claimant's claim are the subject of the same arbitration agreement. The arbitral tribunal may rule on the counter obligation when the arbitration agreement, which becomes the basis for the claimant' claim, has an effect on the counter obligation. Where the claimant fails to raise an objection even after he/she becomes aware that the respondent has requested for arbitration or has raised a plea for set-off by providing his/her claim which is not the subject of the arbitration agreement as a counterclaim or a counter obligation, the arbitral tribunal may rule on the respondent's claim against the claimant. On these occasions, the arbitral tribunal has to guarantee the parties an opportunity to defend themselves by pointing out those situations. It will meet the purposes of arbitration systems to rule out the jurisdiction of the courts when the plaintiff alleges the existence of the arbitration agreement, in case the respondent raises a plea for set-off based on his/her claim which is not the subject of the arbitration agreement in the litigation procedures. However, where the plaintiff fails to allege the existence and conducts pleading in the court with regard to the counter obligation, the court must not reject the respondent's set-off defense because of the existence of the agreement.
This paper considers the price at time zero of a contingent claim when the process is a diffusion/point process model . And we apply this price to European option.
Kim, Kil-Chan;Park, Kyoung-Mi;Eom, Sun-Yong;Lee, Myeong-Hun
The Journal of the Korea Contents Association
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v.11
no.7
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pp.508-518
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2011
In various urban renewal projects related to real estate, developer in order to conduct the business, must get real estate inside project section directly or receive the consent for project from the owners. It must be carried out by consultation. When it fails, developer, in order to get ownership, adopts 'the Right of Claim for the sale' which has forcibleness. However, because the procedure for implementation of the right of claim for the sale is not clear, conflict between stakeholders is caused and it causes extension of period. Therefore, after examining judgments and references of judicial power for administrative litigation of the Right of Claim for the sale, by researching stakeholders of the housing rebuilding project and based on the results, finding out differences of stakeholders' recognition according to their position and problems of exercising procedure of the Right of Claim for the sale, and by presenting improvement plans of the system of the Right of Claim for the sale, contributing the success of the housing rebuilding project is the purpose of it.
This Study aims to investigate the patterns and causes of the time to return-to-work(RTW) of the injured workers. This study collected data with structured questionnaires and finally included 791 injured workers. The Kaplan-Meier method is used for describing the patterns of the time to RTW after the injury and after claim closure. And the Cox regression is used to identify significant factors on the time to RTW after the injury and after claim closure. The results show that amom the all respondents, the 2.65% returned to work within 1 month, 28.82% within 6 months, 50.95% within 1 year, 71.69% within 2 years after the injury, and the 29.46% of the all repondent returned to work before claim closure or directly after the claim closure, the 36.41% returned to work within 1 month, 56.64% within 6 months, 67.54% within 1 year after the claim closure. And the Cox regression results of the time to RTW after the injury show that the time to RTW affected by gender, age, income, the retirement during the treatment, the RTW to the company at injured time, injury type, surgery, the claim duration, disability ratings, vocational training. Also, the Cox regression results of the time to RTW after the claim show that the time to RTW affected by gender, age, income, the return to the company at injured time, disability ratings, vocational training. As a result, some implication and policies are suggested for reducing the time to RTW of the injured workers.
Harpriya Kaur;Steven J. Wurzelbacher;P. Tim Bushnell;Stephen Bertke;Alysha R. Meyers;James W. Grosch;Steven J. Naber;Michael Lampl
Safety and Health at Work
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v.14
no.4
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pp.406-414
/
2023
Background: This study examined age-group differences in the rate, severity, and cost of injuries among construction workers to support evidence-based worker safety and health interventions in the construction industry. Methods: Ohio workers' compensation claims for construction workers were used to estimate claim rates and costs by age group. We analyzed claims data auto-coded into five event/exposure categories: transportation incidents; slips, trips, and falls (STFs); exposure to harmful substances and environments; contact with objects and equipment (COB); overexertion and bodily reaction. American Community Survey data were used to determine the percentage of workers in each age group. Results: From 2007-2017, among 72,416 accepted injury claims for ~166,000 construction full-time equivalent (FTE) per year, nearly half were caused by COB, followed by STFs (20%) and overexertion (20%). Claim rates related to COB and exposure to harmful substances and environments were highest among those 18-24 years old, with claim rates of 313.5 and 25.9 per 10,000 FTE, respectively. STFs increased with age, with the highest claim rates for those 55-64 years old (94.2 claims per 10,000 FTE). Overexertion claim rates increased and then declined with age, with the highest claim rate for those 35-44 years old (87.3 per 10,000 FTE). While younger workers had higher injury rates, older workers had higher proportions of lost-time claims and higher costs per claim. The total cost per FTE was highest for those 45-54 years old ($1,122 per FTE). Conclusion: The variation in rates of injury types by age suggests that age-specific prevention strategies may be useful.
A fisher means any person employed to provide his/her labor in a fishing vessel in exchange for a wage. There is no concept of a fisher in Seafarers Act. This act shall not apply to seafarers who are in service on board a fishing vessel the gross tonnage of which is less than 20 tons. However, of the total 63,112 fishing vessels, only 2,829 fishing vessels have a total tonnage of more than 20 tons. Fishermen engaged in fishing vessels with a gross tonnage of which is less than 20 tons are not guaranteed to be paid arrears through the Wage Claim Guarantee Fund for Seafarer (Article 56). In addition, fishermen working on a fishing vessel are excluded from the Wage claim Guarantee Act. The Labor Standards Act shall apply to fishermen engaged in fishing vessels with a gross tonnage of which is less than 20 tons. Fishermen and seafarers are at a higher risk of living security than regular workers. Guaranteeing the payment of wages is essential for fishermen to improve the life and employment stability. In order to guarantee fisher wage claims, the concept of a fisher in the Seafarers Act must be realized by sources such as the Wage Claim Guarantee Fund of Ministry of Oceans and Fisheries, step by step expansion of members in the wage claim guarantee fund for seafarers and interest for delayed payment of wages, etc.
The value of using health insurance claim database is continuously rising in healthcare research. In studies where comorbidities act as a confounder, comorbidity adjustment holds importance. Yet researchers are faced with a myriad of options without sufficient information on how to appropriately adjust comorbidity. The purpose of this study is to assist in selecting an appropriate index, look back period, and data range for comorbidity adjustment. No consensus has been formed regarding the appropriate index, look back period and data range in comorbidity adjustment. This study recommends the Charlson comorbidity index be selected when predicting the outcome such as mortality, and the Elixhauser's comorbidity measures be selected when analyzing the relations between various comorbidities and outcomes. A longer look back period and inclusion of all diagnoses of both inpatient and outpatient data led to increased prevalence of comorbidities, but contributed little to model performance. Limited data range, such as the inclusion of primary diagnoses only, may complement limitations of the health insurance claim database, but could miss important comorbidities. This study suggests that all diagnoses of both inpatients and outpatients data, excluding rule-out diagnosis, be observed for at least 1 year look back period prior to the index date. The comorbidity index, look back period, and data range must be considered for comorbidity adjustment. To provide better guidance to researchers, follow-up studies should be conducted using the three factors based on specific diseases and surgeries.
Purpose: This study aims to explore the impact of green products' claim skepticism on green purchase intention and further investigates the moderating role of environmental concern in the relationship. This study, by drawing the persuasion knowledge model expected that ambiguity avoidance penalizes less familiar brands than familiar brands. Further, the present study building on Hofstede's cultural dimension, specifically, uncertainty avoidance, undertook a scenario to understand any difference that exist between uncertainty avoidance cultural groups. This study also investigates gender differences in green claim skepticism and proclivity to purchase green products. Research design, data, and methodology: For analyzing the relationship relevant hypotheses were designed, and R-programming software was used. To test the hypotheses two independent sample t-test and regression analysis were carried out. Results: The results suggest that consumers' skepticism toward green claims influenced the intention to purchase eco-friendly products. The study finding also confirms the effect is moderated by environmental concern. Also, the findings of two scenarios reveal that consumers in high uncertainty avoidance culture exhibited a greater level of skepticism for green print advertising and green packaging claims when the brand in the advertising and packaging was unfamiliar than when it was familiar. Conclusions: To alter the negative effect of skepticism the consumer should believe the environmental claims are valid so that they can contribute to solving sustainability issues.
Journal of The Korean Association For Science Education
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v.26
no.5
/
pp.620-636
/
2006
The purpose of this study was to analyze one science teacher's understanding of student argumentation and his explicit teaching strategies for implementing it in the classroom. One middle school science teacher, Mr. Field, and his students of 54 participated in this study. Data were collected through three semi-structured interviews, 60 hours of classroom observations, and two times of students' lab reports for eight weeks. Coding categories were developed describing the teacher's understanding of scientific argumentation and a description of the main teaching strategy, the Claim-Evidence Approach, was introduced. Toulmin's approach was employed to analyze student discourse as responses to see how much of this discourse was argumentative. The results indicated that Mr. Field defined scientific inquiry as the abilities of procedural skills through experimentation and of reasoning skills through argumentation. The Claim-Evidence Approach provided students with opportunities to develop their own claims based on their readings, design the investigation for evidence, and differentiate pieces of evidence from data to support their claims and refute others. During this approach, the teacher's role of scaffolding was critical to shift students' less extensive argumentation to more extensive argumentation through his prompts and questions. The different level of teacher's involvement, his explicit teaching strategy, and the students' scientific knowledge influenced the students' ability to develop and improve argumentation.
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