• 한국화재소방학회:학술대회논문집
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• 한국화재소방학회 2010년도 추계학술발표회 자료집
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• pp.52-62
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• 2010

우리나라 손해보험 업계의 경영실적을 보면 2003년부터 2007까지 5년간 연평균 1조 1,130억원의 당기순이익이 발생하였으나 이는 투자이익에 기인한 것이고 손해보험사업 본업인 보험영업 손익에 있어서는 연평균 5,218억원의 손실을 기록하고 있다. 이와 같이 손실이 발생한 원인은 손해율 증감에 따른 보험요율의 조정미흡, 손해율상승 및 사업비 증가 등의 요인이 있으나 근본적인 요인은 해외 출수재의 불균등과 과다한 해외출재로 인한 수지차의 역조현상에 기인하고 있다. 특히 화재위험을 담보하고 있는 보험상품인 화재보험과 재산종합보험의 출재보험료는 약3,670억원으로써 전체 해외출재보험료에서 가장 높은 30.8%를 차지하고 있다. 이는 방재기술(Loss Control)의 활용미흡과 방재기술에 근간을 두고 있지 못한 보험인수 정책 즉 언더라이팅(Underwriting)기법의 낙후 때문이라고 할 수 있다. 따라서 전통적인 보험 상품인 화재보험에서 보험인수시 물건의 위험도를 측정할 수 있는 화재위험도 평가기법이 필요하고 이를 근간으로 위험을 인수하고 보유의 규모를 결정할 수 있는 체계의 구축이 필요한 실정이다. 이에 본 연구에서는 특정물건의 화재보험 인수과정에서 건물에 내재된 잠재 화재위험의 고저 또는 양 불량을 판정할 수 있는 화재위험도 평가 모형을 개발한 후 이 평가 모형에서 산출된 화재위험도보유계수를 활용하여 보유금액을 결정할 수 있는 보험인수 모형을 도출 하였다.

• 한국중재학회지:중재연구
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• 제29권2호
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• pp.225-237
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• 2019

Recently, it has been argued that it is necessary to attract foreign patients outside domestic insurers and to allow foreign doctors to treat in domestic hospitals in order to develop the insurance industry and revitalize the medical industry. Currently, large medical institutions in Korea are attracting foreign patients in connection with foreign insurance companies. It is desirable to increase the number of overseas patients who want excellent medical services in Korea, and to provide opportunities for domestic insurance companies to attract overseas patients by expanding job creation through a revitalization of the medical industry. Therefore, this study suggests the development direction for insurers who aim to attract foreign patients through the side effects of attracting foreign patients in accordance with the Financial Services Commission's plan to strengthen the competitiveness of the financial industry. In addition, this study intends to contribute to the strengthening of the competitiveness of attracting foreign patients, through domestic insurance business, to the insurance direct payment market for overseas patients using domestic medical institutions that are concentrated in foreign insurance companies and in the blind spot of domestic law application.

• The Journal of Asian Finance, Economics and Business
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• 제9권4호
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• pp.213-228
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• 2022

This paper investigates the association between key corporate governance characteristics and the performance of general insurance businesses listed on the Saudi stock exchange (TADAWUL). The methodology for the study is based on a pooled data collection for 11 Saudi general insurance companies from 2011 to 20. The linear regression model and the logarithm regression model are suggested to assess the relationship between performance and corporate governance characteristics. The dependent variable is firm performance measured using ROA, ROE, and Tobin's Q. The independent variables are corporate governance variables consisting of a complete set of board and audit committee characteristics. Insurer-specific control variables are introduced. The empirical results reveal that the characteristics of corporate governance influence the performance of insurance companies. In particular, the board size, board's tenure, the proportion of independent directors in the board, audit committee size, audit committee meeting frequency, and proportion of health insurance premiums have a positive impact. However, audit committee independence, size of the company, and proportion of reinsurance premiums have a negative impact on the performance of the Saudi general insurance companies. Finally, the empirical results indicated also that there is an unclear relationship between the performance and board meeting frequency, compensations of the Board, and the average age of the Board.

• 대한조현병학회지
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• 제22권1호
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• pp.8-13
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• 2019

Objectives: The aim of this study was to explore the prevalence of type 1 diabetes in patients with schizophrenia and their total medical costs and risk of hospitalization. Methods: This study used Health Insurance Review and Assessment Service data in Korea. To examine total medical costs and risk of hospitalization, we selected 1,510 subjects with schizophrenia (half with and half without type 1 diabetes) that were 1:1 matched via propensity score matching. In health care system perspective, total medical costs included out-of-pocket and insurer's costs. Logistic regression models were used to examine the risk of hospitalization. Results: The prevalence of type 1 diabetes in patients with schizophrenia was 3.87 per 1,000 person year. Among patients with schizophrenia, the amount of total average medical costs and hospitalization costs in patients with type 1 diabetes was 1.49 and 1.59 times higher than those in patients without it, respectively. The odds of hospitalization were higher among patients with type 1 diabetes compared with those without it (odds ratio, OR=1.97 ; 95% CI 1.60-2.43). Conclusion: This study showed that medical costs and risk of hospitalization were higher in schizophrenia patients with type 1 diabetes. Therefore, these individuals may require specific care programs.

• 아태비즈니스연구
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• 제14권4호
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• pp.275-287
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• 2023

Purpose - The purpose of this study is to analyze the relationship between the issuance amount of subordinated bonds and firm value, aiming to determine how subordinated bonds are evaluated in the capital market. Design/methodology/approach - To achieve the research objective, this study empirically analyzes all samples of domestic listed insurers that have issued subordinated bonds. Through such empirical analysis, the study aims to confirm the value relevance of the recognized debt and examine how subordinated bonds are reflected in the firm valuation of insurers. Findings - The research finding indicates that subordinated bonds issued by insurers, despite being recognized as debt, did not show a significant relation with firm value. This result suggests a divergence from the typical characteristics of debt, reflecting the distinct evaluation of debt recognized through the issuance of subordinated bonds(subordinated debt) and general debt in the capital market. In this regard, additional investigation into the value relevance by categorizing debt into general debt and subordinated debt revealed a significant difference in the value relevance of the two types of debt. Research implications or Originality - These research findings indicate that the market evaluation of subordinated debt takes into consideration the economic attributes of the subordinated debt. Furthermore, this evaluation is interpreted to account for the regulatory consideration that recognizes subordinated debt as available capital for supervisory purpose.

• 의료법학
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• 제16권2호
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• pp.87-130
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• 2015

국민건강보험공단이 인신사고의 피해자에게 요양급여를 시행한 후 가해자에게 요양급여비용 중 공단부담금을 구상하는 사건에서 판례는 국민건강보험법이 정하는 청구권대위와 산업재해보상보험법이 정하는 청구권대위를 동일하게 취급하면서, 상계 후 공제설에 따른 공제 범위로부터 국민건강보험공단의 구상 범위를 도출하여 피해자의 손해배상채권액 내에서 공단이 부담한 요양급여비용 전부의 구상을 인정하고 있다. 그러나 국민건강보험법과 산업재해보상보험법은 모두 사회보험을 규율하는 법이지만, 국민건강보험법 요양급여는 '보장비율을 정한 일부 보험'의 성격을 띠고 있는데 비하여 산업재해보상보험법상 보험급여는 전부 보험의 성격을 보이거나 사회보험적 성격에 따라 손해액과 무관하게 산재를 당한 피보험자가 기존 생활에 가까운 생활을 영위하도록 보조하는 데 중점이 있다. 따라서 건보법상 청구권대위와 산재법상 청구권대위를 동일하게 취급할 이유는 없다. 피보험자는 보험금을 수령하는 대신 보험자가 대위에 의하여 취득하는 청구권을 상실하게 되므로 그 범위에서 보험금의 수령으로 인한 이익이 없다. 따라서 피보험자가 가해자를 상대로 손해배상을 구하는 소송에서 손익상계의 법리는 적용될 여지가 없고, 청구권대위의 범위나 손해배상에서 공제할 공제액은 당사자 사이의 약정이나 관계 법령에 따라 정하여야 한다. 따라서 판례가 상계 후 공제설로부터 국민건강보험공단의 구상 범위를 도출하는 것은 타당하지 않다. 국민건강보험공단의 구상 범위를 정한 국민건강보험법 제58조 제1항을, 손해배상이 먼저 이루어진 경우 국민건강보험공단의 면책 범위를 정한 같은 조 제2항과 결합하여 통일적, 체계적으로 해석하면, 국민건강보험공단의 구상 범위는 지급한 요양급여비용에 가해자의 책임 비율을 곱하여 정하는 것이 타당하다. 이는 산업재해보상보험법 제87조 제1항과 제2항의 해석상 근로복지공단의 구상 범위가 지급한 보험급여 내에서 피보험자의 청구권 전액에 미치는 것과 대비된다. 한편, 판례가 국민건강보험공단의 구상 범위를 판단하면서 그 전제로 삼은 상계 후 공제설은 피해자에게 손해액 이상의 이익을 귀속시키지 않는다는 목적을 이루기 위해서 피해자가 얻은 이익을 손해액에서 공제하면 족한데도 왜 그 이익을 손해배상채권액에서 공제하여야 하는지, 피해자가 입은 손해는 공평하게 분배하면서도 피해자가 얻은 이익은 모두 가해자에게 귀속시키는 것이 타당한지, 실제 사례에서 구체적 타당성이 있는지에 관하여 의문이 있다. 따라서 국민건강보험공단의 구상범위에 관한 판례 법리와 상계 후 공제설을 따르는 판례 법리는 재검토되어야 한다.

• 무역상무연구
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• 제39권
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• pp.59-85
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• 2008

An independent bank guarantee(aka an independent guarantee) is provided as an security on a principal obligor's performance of his obligation, and a guarantor should pay the guaranteed amount only upon a beneficiary's written demand. A standby letter of credit has been used in the United States, since it was construed that a bank should not issue a guarantee. There was wide misunderstanding that a standby letter of credit differs from an independent bank guarantee. However, a standby letter of credit is the same security as an independent bank guarantee, and in international business a standby letter of credit is not differentiated from a independent bank guarantee. An independent bank guarantee are independent from the underlying contract, unconditional, and irrevocable. And a guarantor should pay upon written demand without proving a principal obligor breaches the underlying contract. These features of an independent bank guarantee has been abused in international transactions. Thus it has been proposed that some exceptions to the features of an independent bank guarantee should be allowed. United Nations Convention on Independent Guarantees and Standby Letter of Credit(1995) stipulates some exceptions to payment obligation. Export bond insurance, a part of export insurances, operated by the Korea Export Insurance Corporation under the Export Insurance Act, is used as a security for unfair calling by a beneficiary under an independent bank guarantee. Most of the export subsides by the government are prohibited under WTO's Agreement on Subsidies and Countervailing Measures. However, as export insurance is allowed under the WTO, it operates a significant role in enhancing the export. In the event that export bond insurance is provided for a guarantor, an obligor who is subject to recourse by a guarantor, can be exempt from the recourse in case of unfair calling. The Korea Export Insurance Corporation, an insurer, bears unfair calling risk by a beneficiary. Generally it is understood that a demand shall be made before the expiry of an independent bank guarantee. However this is not absolutely true, it shall be decided by URDG, ISP98, the governing law.

• 약학회지
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• 제57권5호
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• pp.369-375
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• 2013

Objective: Using the Korean Health Panel data (KHP) of 2008 and 2009, this paper analyzed the effect of antihypertension medication adherence on the changes in medical service utilization and medical expenditure in the next year. Method: Through a face-to-face interview survey, KHP has provided an extensive data on demographic characteristics, medical utilizations behavior, medical expenditure and health behaviors of the targeted households and their members since 2008. KHP is recognized as highly accurate regarding medical expenditure in that it makes the target households to record 'Health diary' whenever they use healthcare service, which could minimize their cognitive bias or memory distortion. The 2010 KHP data was based on the interview from 6,432 households and 19,697 household members. Two part model was used to explore the effects of medication adherence on medical use (logistic regression analysis) and medical expenditures (OLS). Result: Our study result demonstrated that the 74.7% of the patients who strictly adhere to their medication in both years, in 2008 and in 2009, were likely to use inpatient service in 2010. This shows the noncompliant patients were in fact use emergency service less than the compliant patients. Conclusion: Based on our analysis, this paper concludes that the high medication adherence of hypertensive patients could contribute to reduce the emergency service use. Therefore it is highly recommendable for the Korean government and the insurer, NHIS, to actively invest in developing education and promotion program to improve medication adherence among hypertensive patients.

• 응용통계연구
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• 제27권1호
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• pp.71-87
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• 2014

손해보험의 신뢰도이론에서 순보험료로 사용되는 베이즈보험료는 꼬리위험을 반영하지 못한다는 한계점이 있다. 본 논문에서는 꼬리위험측도를 이용하여 할증보험료를 결정하는데 있어 중요하다고 여겨지는 두 가지 주제를 다루었다. 첫째, 위험측도로부터 유도되는 안전할증은 내재된 담보의 위험을 보다 정확히 반영할 수 있으며, 동시에 베이즈보험료만을 사용할 경우 초래될 수 있는 잘못된 의사결정을 피할 수 있음을 보였다. 둘째, 동일한 사전분포가 주어지더라도 서로 다른 조건부손실분포의 꼬리위험 순위와 그에 상응하는 예측분포의 꼬리위험순위는 일반적으로 다를 수 있음을 모수적 모형에 기반하여 보였다. 따라서 안전할증은 조건부손실분포의 위험측도가 아니라 예측분포의 위험측도를 사용해야 함을 알 수 있다.

• 한국의료질향상학회지
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• 제12권2호
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• pp.75-83
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• 2006

Background : Utilization review has been adopted as a vehicle for cost and utilization control of health care services. Its role was further stressed and expanded through the establishment of Health Insurance Review Agency in 2001. This article is to introduce concept, activities, and effect of utilization review based on the experiences of U.S. and to suggest important characteristics for ideal utilization review activities at the national level in Korea. Method : Twenty-five articles related with utilization review were reviewed after being selected through web site search through Med Line and Richis. Result : Utilization review was introduced mainly for health care expenditure control either by insurer, provider or the third parties under the pressure of increasing health care cost. It's activities can be categorized to prospective, concurrent and retrospective review according to the time of service provision. Based on most of studies, utilization review has been effective in controling rising health care cost and utilization. However it's effectiveness assumes a reimbursement structure of managed care like capitation payment. More worse, it is still unknown it's effectiveness on quality of care. Conclusion : Utilization review should be employed to increase the cost effectiveness of medical care by optimizing quality and patient's outcomes while also attempting to reduce the use of resources. So, it should consider outcomes before expenditures, check for both under and over-use, and construct an structure in which consumption is reduced equitably. Aggressive adoption of utilization review in Korean health care setting with fee-for-service reimbursement structure might not be a cost-effective approach before adoption of prospective payment system such as D.R.G. and capitation.