• International conference on construction engineering and project management
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• 2015.10a
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• pp.710-711
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• 2015

A nuclear power plant construction is a complex form of construction which comprises various stakeholders and contractors. Therefore, contract disputes will occur due to conflicting interests of contracting parties and unpredictable factors which arise during construction work. Even if the contract is well prepared, it cannot fully prepare for future situations in actuality. Claims management is very important in carrying out construction management. This study intends to define claim, and delve into development of claims management processes from the viewpoint of owners and contractor through consideration on international contract terms on claims management and the details of the claims management of the Construction Extension to the PMBOK. In addition, it is needed to accumulate and manage data on claims that have occurred so that they can be referenced in the future. As information should be accumulated so that type classification can be carried out and that lessons can be learned on claims that have occurred in each business site, study on establishing data-based systems relating to claims processes will be needed in the future.

• Proceedings of the Korean Institute Of Construction Engineering and Management
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• autumn
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• pp.442-445
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• 2002

Construction delay claim occurs more often than any other claim. Delay claim impacts adversely the company's existence as well as the project's monetary problem. Because the calculation of the delay is not quantitative, owing not to have enough evidence, it is hard to solve evenly the delay claim. So, it is need to cumulate structurely the construction data or evidence during the construction. This study considers the established study about construction delay claim database and the problems and then presents the relation method between phase schedule and database. Finally, this study established the productivity claim database modeling for construction project through conceptual database modeling and logical database modeling based on information needed to make construction productivity database. So. the purpose of the study is to establish the datamodel for productivity management of construction project for calculating the delay days considering the lost productivity.

• International conference on construction engineering and project management
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• 2022.06a
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• pp.57-66
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• 2022

Claims and disputes are major causes of cost and schedule overruns in the construction business. In order to manage claims and disputes effectively, it is necessary to analyze various types of contract documents punctually and accurately. Since volume of such documents is so vast, analyzing them in a timely manner is practically very challenging. Recently developed approaches such as artificial intelligence (AI), machine learning algorithms, and natural language processing (NLP) have been applied to various topics in the field of construction contract and claim management. Based on the systematic literature review, this paper analyzed the goals, methodologies, and application results of such approaches. AI methods applied to construction contract management are classified into several categories. This study identified possibilities and limitations of the application of such approaches. This study contributes to providing the directions for how such approaches should be applied to contract management for future studies, which will eventually lead to more effective management of claims and disputes.

• International conference on construction engineering and project management
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• 2005.10a
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• pp.1171-1176
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• 2005

Dispute related to construction projects involving numerous persons is one of the biggest challenges faced by contractors today. It costs a substantial amount of money and time in resolving these kinds of claims. Recently, with the changes in the construction environment and thought of relation with owner, the number of construction claims has increased. But, a majority of these claims do not prevail, and in fact, frequently get dismissed in its entirety. The reasons for such dismissals include the ignorance about the claims, lack of clear and convincing evidence, and so on. But most of reasons are the claims are not managed well on construction process. This paper analyzes the failure causes by relying on past claim failure cases, and then drew works that have connection with failure causes through interview. It also presented importance degree of construction management works.

• 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.

• International conference on construction engineering and project management
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• 2017.10a
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• pp.281-290
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• 2017

As various stakeholders are involved in construction projects, disputes between the parties are more likely to occur, which is a very important issue for the participants in the projects. Claims in construction projects, however, are very complex and thus difficult to manage. In particular, as the cause of a claim in the preceding stage that has not been resolved in a timely manner has an effect on the cause of a claim in the following stage, it is difficult to find a point of compromise regarding a claim caused by the relationship between the causes that occur in the preceding and following stages. In this regard, this study sought to examine the rules for the generation of change order claims, which occur most frequently among the construction claims, and thus to select the key management targets through the analysis of the relationship between the causes of claims arising in the preceding and following stages for the efficient management of claims. It is expected that the use of rules for the generation of change order claims as well as of representative and similar cases will help the construction practitioners in judging claims, considering the relationships among the causes of the claims. Meanwhile, in this study, association analysis was conducted regarding the causes of the occurrence of change order claims in a design-build delivery method, and therefore, it is necessary to verify the effectiveness of the method when applied to other delivery methods.

• Bulletin of the Korean Mathematical Society
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• v.52 no.3
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• pp.895-906
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• 2015

Recently, Li [12] gave an asymptotic formula for the ultimate ruin probability in a delayed-claim risk model with constant force of interest and pairwise quasi-asymptotically independent and extended-regularly-varying-tailed claims. This paper extends Li's result to the case in which the risk model is perturbed by diffusion, the claims are consistently-varying-tailed and the main-claim interarrival times are widely lower orthant dependent.

• Journal of Preventive Medicine and Public Health
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• v.39 no.5
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• pp.433-437
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• 2006

Objectives: The aim of this study is to develop a methodology for estimating a nationwide statistic for hernia operations with using the claim database of the Korea Health Insurance Cooperation (KHIC). Methods: According to the insurance claim procedures, the claim database was divided into the electronic data interchange database (EDI_DB) and the sheet database (Paper_DB). Although the EDI_DB has operation and management codes showing the facts and kinds of operations, the Paper_DB doesn't. Using the hernia matched management code in the EDI_DB, the cases of hernia surgery were extracted. For drawing the potential cases from the Paper_DB, which doesn't have the code, the predictive model was developed using the data mining technique called SEMMA. The claim sheets of the cases that showed a predictive probability of an operation over the threshold, as was decided by the ROC curve, were identified in order to get the positive predictive value as an index of usefulness for the predictive model. Results: Of the claim databases in 2004, 14,386 cases had hernia related management codes with using the EDI system. For fitting the models with applying the data mining technique, logistic regression was chosen rather than the neural network method or the decision tree method. From the Paper_DB, 1,019 cases were extracted as potential cases. Direct review of the sheets of the extracted cases showed that the positive predictive value was 95.3%. Conclusions: The results suggested that applying the data mining technique to the claim database in the KHIC for estimating the nationwide surgical statistics would be useful from the aspect of execution and cost-effectiveness.

• Proceedings of the Korean Institute Of Construction Engineering and Management
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• autumn
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• pp.287-291
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• 2002

A construction claim is generally caused by several causes, and in the case of developed countries, the most fundamental problem in most claims is a delay claim. Also, it is predicted that the trouble will increase by this one in a domestic case as well. Even though the construction claims occurred by the delay claim are the most frequent ill construction project, it is very difficult to analyze due to the complexity of occurring forms. Therefore, the rational judgement and the solving method need to be concerned through the accurate understanding the clauses accepted in a international contract execution and a domestic contrail when the claim occurred. The purpose of this study is to present problems and improving methods by comparing FIDIC with a domestic accounting regulation in order to expand a general condition into the international contract condition.