• Title/Summary/Keyword: Claims problem

Search Result 104, Processing Time 0.02 seconds

Fuzzy PID Control of Warranty Claims Time Series (보증 클레임 시계열 데이터를 위한 퍼지 PID 제어)

  • Lee, Sang-Hyun;Lee, Sang-Joon;Moon, Kyung-Il;Cho, Sung-Eui
    • Journal of Information Technology Services
    • /
    • v.8 no.4
    • /
    • pp.175-185
    • /
    • 2009
  • Objectifying claims filed during the warranty period, analyzing the current circumstances and improving on the problem in question is an activity worth doing that could reduce the likelihood of claims to occur, cut down on the costs, and enhance the corporate image of the manufacturer. Existing analyses of claims are confronted with two problems. First, you can't precisely assess the risks of claims involved by means of the value of claims per 100 products alone. Second, even in a normal state, the existing approach fails to capture the probabilistic conflicts that escape the upper control limit of claims, thus leading to wrong control activities. To solve the first problem, this paper proposed that a time series detection concept where the claim rate is monitored based on the date when problems are processed and a hazard function for expression of the claim rate be utilized. For the second problem, this paper designed a model whereby to define a normal state by making use of PID (Proportion, Integral, Differential) and infer by way of a fuzzy concept. This paper confirmed the validity and applicability of the proposed approach by applying methods suggested in the actual past data of warranty claims of a large-scaled automotive firm, unlike hypothetical simulation data, in order to apply them directly in industrial job sites, as well as making theoretical suggestions for analysis of claims.

Allocating CO2 Emission by Sector: A Claims Problem Approach (Claims problem을 활용한 부문별 온실가스 감축목표 분석)

  • Yunji Her
    • Environmental and Resource Economics Review
    • /
    • v.31 no.4
    • /
    • pp.733-753
    • /
    • 2022
  • Korean government established the Nationally Determined Contribution (NDC) in 2015. After revising in 2019, the government updated an enhanced target at the end of last year. When the NDC is addressed, the emission targets of each sector, such as power generation, industry, and buildings, are also set. This paper analyzes the emission target of each sector by applying a claims problem or bankruptcy problem developed from cooperative game theory. The five allocation rules from a claims problem are introduced and the properties of each rule are considered axiomatically. This study applies the five rules on allocating carbon emission by sector under the NDC target and compares the results with the announced government target. For the power generation sector, the government target is set lower than the emissions allocated by the five rules. On the other hand, the government target for the industry sector is higher than the results of the five rules. In other sectors, the government's targets are similar to the results of the rule that allocates emissions in proportion to each claim.

Claims Insurance Medicine (클레임보험의학)

  • Lee, Sin-Hyung
    • The Journal of the Korean life insurance medical association
    • /
    • v.30 no.2
    • /
    • pp.8-11
    • /
    • 2011
  • Insurance medicine has been known to medical risk selection. The role of insurance medicine is sound maintenance of insurance system. So it's function is medical underwriting of life risks. However, emerging market has insufficient medical epidemiological research that is necessary for estimation of extra-risk and such market is usually lack of full understanding of life insurance among insurance customers. This problem makes difficult of performing the medical underwriting, as an original insurance medicine. Medical contributions at the stage of claims adjudication comparing the coverage provided in the product, with the information provided in the claims, based on medical records and the agreement between them. This is called medical verification. The insurance doctors can also use their medical knowledge to help the claims staff with informing claimants about the medical basis of claims decisions.

  • PDF

An Analysis of Written Claim and Evidence Produced by Secondary Science Teachers in a Context of Chemistry Inquiry (화학 탐구 맥락에서 중등 과학 교사가 제시한 주장과 증거 분석)

  • Kim, DaEun;Choi, Aeran
    • Journal of the Korean Chemical Society
    • /
    • v.61 no.6
    • /
    • pp.359-368
    • /
    • 2017
  • The purpose of this study was to examine levels of claims and evidence produced by 53 secondary science teachers. Levels of claim and evidence produced by the teachers in this study are various depending on themes. For a problem integrated several science concepts, there were many teachers who produced claims and evidence in a level of 1 or 2. The participant teachers presented claims and evidence in a level of 3 or 4 for a problem related to chemistry concepts presented in chemistry textbooks. Professional development programs should be provided for science teachers to help them develop understanding of argument structure and construct high quality of claims and evidence.

The Legal Consideration in Emergency Medical Service System (의료분쟁에 관한 보건정책학적 고찰 -응급의료종사자를 중심으로-)

  • Kang, Byung Woo
    • The Korean Journal of Emergency Medical Services
    • /
    • v.3 no.1
    • /
    • pp.91-101
    • /
    • 1999
  • The medicolegal problem can be occurred in all medical field. Especially pre-hospital stage can be more exposed to the legal claims due to the very nature of EMT business and characteristics of ER patient or their family member. All Emergency Medical Technician should be concerned about the law associated with emergency care for handling the medicolegal problem, so the legally risky situations that may be occurred in pre-hospital stage and ER practice. This study reviewed malpractice claim of emergency patients filed in at Association of malpractice patients' family and two tertiary level hospitals. Problems related to treatment and misdiagnosis. Especially issues concerning emergency medical service system including of inadequate transport, delay in triage and transport accounted for many cases of all claims. This alerts us to the seriousness of medical accidents of emergency patient. This paper suggests several items that all E.M.T and every member of ED health care team always have to remember the medicolegally risk situations, must be trained in understanding the patients' wants and desires and should have the knowledge of the law associated with emergency health care. Develop the system that can share the informations about the medicolegal events which were experienced by each ED health care institutes.

  • PDF

파산절차에 관한 경제학적 분석

  • Ryu, Geun-Gwan
    • KDI Journal of Economic Policy
    • /
    • v.23 no.1_2
    • /
    • pp.149-191
    • /
    • 2001
  • In this paper, we propose a new bankruptcy algorithm. The proposed algorithm is comprised of four tasks. Task A is the procedure of soliciting bids, Task B is the procedure of allocating claims, Task C is the procedure of trading claims, and Task D is the procedure of exercising options and holding shareholders' meeting. Tasks A, B, and D are based on Bebchuk(1988) and Aghion, Hart, ad Moore(1992). This paper adds Task C, the procedure of trading claims. Claims are in the form of options which are written on the new shares of the bankrupt firm. Trading options expedites the process of finding the value of the bankrupt firm, and also it mitigates the problem of incomplete capital market by expanding the pool of new investors.

  • PDF

The Effects of Aronia Extract on Body Weight and Body Fat: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial (체지방에 대한 아로니아 추출물의 효과: 무작위배정, 이중눈가림, 위약-대조 임상연구)

  • Ha, Ki Chan;Park, Yu Kyung;Baek, Hyang Im;Kim, Hye Mi;Kim, Young Mi;Jeong, Da Young;Shin, Sang Wook;Bae, Jung Shik;An, Ji Hye;Jeon, Yeon Jeong;Park, Ji Eun;Kwon, Young Dal
    • Journal of Korean Medicine Rehabilitation
    • /
    • v.30 no.1
    • /
    • pp.105-113
    • /
    • 2020
  • Objectives Excess weight and obesity are a crucial public health problem worldwide and are considered as the main cause of many chronic diseases. The present study evaluated the effects of Aronia melanocarpa extract (AMEX) supplementation on body compositions in overweight or obese people. Methods This randomized, double-blind, placebo-controlled clinical trial was carried out on 66 healthy overweight or obese peoples. The eligible subjects were divided into AMEX and placebo supplement treatment for 12 weeks. Anthropometrics, body composition (dual-energy X-ray absorptiometry), and blood analysis were performed preand post intervention. Results We observed significant reductions in the body weight and body mass index in both groups; however, the decrease was higher in the AMEX group. Body fat mass and percent body fat showed a tendency to decreases after AMEX supplementation. No clinically significant changes were observed for any safety parameter. Conclusions In conclusion, the data of this trial indicate that AMEX were not effective in reducing body compositions, but as a safe supplement, it may help weight loss in overweight or obese people.

On Feasibility of Ambulatory KDRGs for the Classification of Health Insurance Claims (KDRG를 이용한 건강보험 외래 진료비 분류 타당성)

  • 박하영;박기동;신영수
    • Health Policy and Management
    • /
    • v.13 no.1
    • /
    • pp.98-115
    • /
    • 2003
  • Concerns about growing health insurance expenditures became a national Issue in 2001 when the National Health Insurance went into a deficit. Increases in spending for ambulatory care shared the largest portion of the problem. Methods and systems to control the spending should be developed and a system to measure case mix of providers is one of core components of the control system. The objectives of this article is to examine the feasibility of applying Korean Diagnosis Related Groups (KDRGs) to classify health insurance claims for ambulatory care and to identify problem areas of the classification. A database of 11,586,270 claims for ambulatory care delivered during January 2002 was obtained for the study, and the final number of claims analyzed was 8,319,494 after KDRG numbers were assigned to the data and records with an error KDRG were excluded from the study. The unit of analysis was a claim and resource use was measured by the sum of charges incurred during a month at a department of a hospital of at a clinic. Within group variance was assessed by th coefficient of variation (CV), and the classification accuracy was evaluated by the variance reduction achieved by the KDRG classification. The analyses were performed on both all and non-outlier data, and on a subset of the database to examine the validity of study results. Data were assigned to 787 KDRGs among 1,244 KDRGs defined in the classification system. For non-outlier data, 77.4% of KDRGs had a CV of charges from tertiary care hospitals less than 100% and 95.43% of KDRGs for data from clinics. The variance reduction achieved by the KDRG classification was 40.80% for non-outlier claims from tertiary care hospitals, 51.98% for general hospitals, 40.89% for hospitals, and 54.99% for clinics. Similar results were obtained from the analyses performed on a subset of the study database. The study results indicated that KDRGs developed for a classification of inpatient care could be used for ambulatory care, although there were areas where the classification should be refined. Its power to predict tile resource utilization showed a potential for its application to measure case mix of providers for monitoring and managing delivery of ambulatory care. The issue concerning the quality of diagnostic information contained in insurance claims remains to be improved, and significance of future studies for other classification systems based on visits or episodes is guaranteed.

Effect of Argumentation Instruction on Medical Student Experiences with Problem-Based Learning (논증강화교육이 의학과 학생의 문제바탕학습 경험에 미치는 영향)

  • Ju, Hyunjung
    • Korean Medical Education Review
    • /
    • v.19 no.2
    • /
    • pp.101-108
    • /
    • 2017
  • When participating in problem-based learning (PBL), it is important for medical students to generate claims and provide justifications for their claims in small group discussions. This study aimed to investigate the effect of argumentation instruction on medical student learning experiences with PBL. A total of one hundred first-year preclinical students from Inje University College of Medicine, who had attended argumentation instruction, participated in this study. All of the participants completed a 5-point Likert scale questionnaire regarding their learning experiences with PBL, before and after the argumentation instruction. The questionnaire comprised 22 items with eight subcategories: argumentation activity, reflection, integration of basic and clinical science, identification of lack of knowledge, logical thinking, self-directed study, communication, and attitude toward discussion. The collected data were analyzed through a paired-sample t-test. The results of this study found that the argumentation instruction promoted the preclinical students' experiences with argumentation activities, reflection, an integration of basic and clinical science, the identification of their lack of knowledge, logical thinking, and self-directed study, and it increased positive attitudes toward group discussion. The findings suggest argumentation instruction can enhance medical student group discussions and help students achieve the objectives of PBL, including acquisition of basic and clinical science knowledge and development of clinical reasoning and self-directed learning abilities, which can highlight the meaningful learning experiences students have with PBL.

Strategy about Support System for Victims of Fire Cases through the Analysis of A Fire Cases (화재사례분석을 통한 화재피해자 지원체계 구축방안)

  • Cha, Jong-Ho
    • Journal of Korean Society of Industrial and Systems Engineering
    • /
    • v.41 no.4
    • /
    • pp.196-202
    • /
    • 2018
  • There have been more than 40,000 cases of fires in Korea in the last three years. However, as 'Accidental Fire Liability Act' was judged to be non-conform to the Constitution in 2007, the damages by light mistakes should be compensated. Accordingly, disputes such as compensation claims, litigations and indemnification cases of the victims of fire increased. However, it is so difficult for victims of fire cases to take proper action. So, this study is to help victims of fire cases in the disputes and compensation claims of the victims, and to find actual and practical support system based on the analysis of compensation status. To help victims of fire cases, we need to survey about victims of fire cases with multiple victims. That survey is analyzed to find support plan for victims. Furthermore, to find support plan the current law is needed to be analyzed and reviewed to revision. It is also tried to identify problems in the operation of the Center for victims of Fire currently operated by fire stations and to find countermeasures. In addition, the status of subscription and problem of fire insurance for the compensation for the victims and the method to increase fire insurance subscription rate will be studied.