• 한국항해학회지
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• 제25권4호
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• pp.487-512
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• 2001

In 1986, the People's Insurance Company of China(hereinafter called PICC) Hull Insurance Clauses, which were amended on the basis of the version 1972, were put into effect. Since PICC is the biggest state-owned insurance company in China, its hull insurance clauses have been used nationwide. In the clauses are included the following contents： scope of cover, exclusions, period of insurance, automatical termination of insurance, duty of assured, claim and indemnity, treatment of disputes and so on. However, this study is only limited to the legal interpretation of the most important clauses relating to indemnity of the insurer. The writers attempt to supply some basic materials necessary for the establishment and enforcement of the Korean hull insurance clauses.

• 수산해양교육연구
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• 제5권2호
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• pp.110-118
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• 1993

A squid gill-net fishing vessel Jayueoroho which was being insured ITC-Hulls and was laid up long period illegally under the condition of unmanned in the Pert of Kamcheon. On 30, March, 1993, the fishing vessel moved out toward the high sea by assistance of two tugboats, 12 miles southeast from Teajongdae, to discharge sewage. At that time the shipowner, the skipper, chief engineer and two labourers were boarding, and a fire was broken out by electric leakage at sea. For all their efforts of fire-fighting operation the fishing vessel foundered with explosion. In this case, she had been breached the warranties of legality, especially Korean maritime acts concerned, and the warranties of seaworthiness(MIA 39(5)) as attributable cause because of unmanned on board by wilful misconduct of the insured. Therefore it is prima facie evidence that the insurer is not liable for any loss attributable to the wilful misconduct and breach of warranties of the insured in MIA 1906.

• 대한수학회보
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• 제56권6호
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• pp.1467-1483
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• 2019

This paper analyzes a robust optimal reinsurance and investment strategy for an Ambiguity-Averse Insurer (AAI), who worries about model misspecification and insists on seeking robust optimal strategies. The AAI's surplus process is assumed to follow a jump-diffusion model, and he is allowed to purchase proportional reinsurance or acquire new business, meanwhile invest his surplus in a risk-free asset and a risky-asset, whose price is described by an Ornstein-Uhlenbeck process. Under the criterion for maximizing the expected exponential utility of terminal wealth, robust optimal strategy and value function are derived by applying the stochastic dynamic programming approach. Serval numerical examples are given to illustrate the impact of model parameters on the robust optimal strategies and the loss utility function from ignoring the model uncertainty.

• 무역상무연구
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• 제4권
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• pp.43-67
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• 1992

• 대한예방한의학회지
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• 제14권2호
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• pp.57-66
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• 2010

Backgrounds : Since December 1, 2009, National Health Insurance began to reimburse for three physical therapies of Korean medicine. The extension of insurance coverage is demanded by Korean medicine societies. Objectives : This study aimed to measure the resource-based relative value scale (RBRVS) scores for thirty four physical therapies of Korean medicine and to estimate the insurer's expenditure for them in National Health Insurance. Methods : To measure the physician's work and the practice expense, the 'magnitude estimation method (MEM)' and the 'fully distributed cost - attributable cost method (FDC-ACM)' were applied respectively. We collected the frequency data of physical therapies from Korean medicine hospitals and clinics to estimate the total expenditure. Results : The resource-based relative value scale scores of physical therapies were measured from 23.44 to 160.66. Total insurer's expenditure was calculated to be 95.5 billion won as of 2009. Conclusions : Based on the result that showed minor increase of total expenditure, most physical therapies of Korean medicine need to be reimbursed in the National Health Insurance.

• 무역상무연구
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• 제46권
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• pp.211-235
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• 2010

According to the commercial law in Korea, a marine cargo insurance contractor (policyholder, insured person, agent) has the duty to disclose risks before establishing an insurance contract and the obligation to notify changes in risks after before establishing the contract. Marine cargo insurance policy clauses include one about the obligation to notify changes in risks. This clause assumes that an insurance contract should be implemented according to what has been answered to the important questions asked by the insurer in connection with the insurant's duty to disclose before establishing an insurance contract, and it stipulates that, if any change in what has been disclosed should be notified to the insurer since it is regarded as a change in risks. Neglecting the obligation to notify may lead to the termination of the appropriate insurance contract by the insurer. The problems here concern the clauses about changes in risks and about the obligation to notify. The problems are like these. Can it be that the circumstances which might be seen in the past as changes in risks according to the territorial sea laws and institute cargo clauses stipulated long ago are considered as such still today? And a marine cargo insurance policy till valid when changes in risks have not been properly notified by the original discloser of risks to the insured who currently holds the marine cargo insurance policy, which, unlike other insurance policies, is a marketable security? In Korea, the commercial law has a clause the obligation to notify changes in risks established based on the territorial sea laws and institute cargo clauses. In this regard, this study aims to consider if the clause still valid today or not and, if not, to propose alternatives to the clauses.

• 보건행정학회지
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• 제19권1호
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• pp.1-30
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• 2009

Korean medical fee contract system between the insurer and healthproviders was introduced in 2000. However, a continuous discord among contracting parties concerned and an irrational operation of an arbitration committee of Ministry for Health, Welfare and Family Affairs (MIHWAF) have made it difficult for them to reach to an agreement over last 8 years. The purpose of this study is to observe the current problems of contract system from the view of health insurance law and actual examples. Furthermore, I examined the of breakdown of negotiation by analyzing the eligibility of contracting parties, rationality of Resource Based Relative Value System (RBRVS) and contracting method and fairness of arbitration method in case of negotiation rupture. The results were as follows: First, since the introduction of medical fee contract system, there has been a problem in that both the president of National Health Insurance Corporation (NHIC) and health care provider association have not held strong negotiation power. Second, the frequent changes and notifications of Relative Value Units (RVUs) without any mutual consent between the insurer and provider association negatively have influenced the conversion factors and finally hindered the agreement of contract. Third, a current process that the conversion factors are mediated and determined at the arbitration committee of MIHWAF in the case of contract breakdown between contracting parties has some flaw in that the irrational composition of committee provoked the lack of fairness and objectivity of mediation. Fourth, we can not prospect a satisfactory outcome of arbitration committee because the mediation always has failed to proceed smoothly due to boycott of both committee members from insurer and providers over last 8 years. As a result, we have to make an every effort to resolve problems mentioned above and then dream of an advanced national health insurance system.

• 무역상무연구
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• 제73권
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• pp.65-90
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• 2017

The rule of warranty in English insurance law was established in the second part of the $18^{th}$ century by Lord Mansfield, who laid the foundations of the modern English law of insurance contract and developed very different rule of insurance law, especially in the field of warranty. At the time of Lord Mansfield, warranty, that is, the promise given by the assured, played an important role for the insurer to assess the scope of the risk. Legal environments, however, have changed since the age of Lord Mansfield. English and Scottish Commissions proposed very dramatic reform of law in the field of warranty law to reflect the changes of legal environment through the Insurance Act 2016. This article intends to consider the legal implications through the comparative analysis between the new regime of warranty in the Insurance Act 2015 and MIA 1906. The major changes in the Insurance Act 2015 are summarized as following. First, Basis of the contract clauses in non-consumer insurance contracts should be of no effect and representations should not be capable of being converted into warranties by means of a policy term or statement on the proposal form. This requirement should not be capable of being avoided by the use of a contract term and the arrangement of contracting out by parties should be of no effect. Secondly, The existing remedy for breach of warranty, that is, automatic discharge of the insurer's liability, should be removed. Instead, the insurer's libility should be suspended from the point of breach of warranty and reattach if and when a breach of warranty has been remedies. Thirdly, A breach of warranty should genally be regarded as remedied where the insured ceases to be in breach of it. In the other hand, for time-specific warranties which apply at or by an ascertainable time, a breach should be regarded as remedies, if the risk to which the warranty relates later, becomes essentially the same as that originally contemplated by the parties. Fourthly, where a term of an insurance contract relates to a particular kind of loss, or loss at a particular location/time, the breach of that term should only give the remedy in relation to loss of that particular kind of loss, or at a particular location/time. Finally, whether a term of an insurance contrat relates to loss of a particular kind of at a particular location/time should be determined objectively, based on whether compliance with that ther would tend to reduce the risk of the occurrence of that category of loss.

• 한국산학기술학회논문지
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• 제11권8호
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• pp.2876-2881
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• 2010

본 논문은 한국 및 독일 보험회사의 해외 진출 모델을 비교 연구한다. 특히, 독일 법률비용보험회사의 한국진출 사례를 분석하여 국내 보험회사의 해외진출에 주는 시사점을 제시한다. 연구방법론으로서 한국 및 독일 보험회사의 해외 진출사례를 수집하여 비교 분석한다. 이를 위하여 각 보험회사의 해외진출 담당자와 면담, 이메일, 전화상담 방법을 사용한다. 그리고 문헌연구를 통하여 연구의 이론적 배경과 기존의 연구결과를 분석한다. 본 연구에서는 보험회사 해외진출의 이론적인 배경으로서 고객지향 현지화전략, 신규특화시장 개척전략, 성장시장 진출전략 3개 요인으로 구분한다. 국내 보험회사는 해외 성장시장 진출 측면에서 긍정적인 반면에 현지화전략과 해외 신규 특화시장 개척 부분에서 아직 개선될 부분이 있는 것으로 분석되었다. 독일 보험회사는 한국 시장에 진출하면서 철저한 현지화전략, 특화시장 개척, 성장시장 진출의 3개 부분에서 모두 긍정적인 것으로 분석되었다. 보험회사 해외진출의 이론적 배경 3개 요인을 적용하여 비교 분석한 결과 독일 보험회사의 사례와 같이 한국 보험 회사가 해외에 진출할 경우에 보다 철저한 현지화 전략과 특화시장 개척 전략이 필요하다는 점을 제시한다. 본 연구의 한계점은 독일 법률비용보험회사 1개사를 대상으로 하고 있다는 점이며, 진출 초기라서 아직 경영실적이 뒷받침 되지 않고 있다는 점이다. 향후 연구과제로서 일정시점이 지난 후에 국내 보험시장에서 독일 법률비용보험회사의 발전추이를 분석하고 법률보험시장에서 도덕적 위태 방지 연구, 소비자 보호를 강화할 수 있는 방안 연구를 향후 연구 과제로 제시한다.

• Journal of Preventive Medicine and Public Health
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• 제28권1호
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• pp.153-174
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• 1995

This study was conducted to examine the determinant factors for expenditure of the medical insurance program for self-employeds based on the analysis of 1991 'The Medical Insurance Program for Self-Employeds Statistical Yearbook', and also similar yearbooks in the metropolitan and other provinces. The major findings are as follows : We have divided benefits into these four components such as the utilization rate for out-patients, expenses per claim for out-patients as paid by the insurer, utilization rate for in-patients, and the expenses per claim for in-patients as paid by the insurer, in order to examine the determinant factors for it. The results of the study revealed the following findings, in urban areas, the supply of medical care had more influence on the benefits than other demographic and economic variables, while, in county areas, both the supply of medical care and the rate of those aged over 65 affected the provision of benefits. The determinant factors for financial balance of the medical insurance program for self-employeds are, first, the determinant factor for administrative expenses was the number of households. The more the number of households, the less the administrative expenses per the insured. This shows that the economy of scale is being. And so, the administrative district must be taken into consideration in the incorporation of small regional medical societies and should be re-organized for more efficient management. Second, in urban areas, the supply of medical care had more influence on utilization rate and expenses per claim as paid by insurer, and therefore it is necessary to control it. In county areas, the supply of medical care and the rate of those aged over 65 raised the utilization rate and expenses per claim as paid by insurer. For the financial stability of county areas, a common fund for medical care for the aged and expansion of finance stabilization fund would be necessary. But, in county areas, it would be unnecessary to control the supply of medical care because it was much more insufficient than in urban areas. The vitalization of public health facilities must be carried out in county areas, for they reduced benefits. Sice the more insured in a single household, the less the utilization of the medical insurance program, benefits for habilitation at home should be given consideration. The law of majority and the economy of scale were applied here, and therefore the incorporation of regional medical societies must be taken into consideration. In integrating regional medical societies, it would be absolutely necessary to review the structural differences among all regional medical societies, the medical demand of each region, and also the local characteristics of each region.