• Title/Summary/Keyword: Insurer

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A Study on the Interpretation of the Insurer's Liability of Indemnity under the Hull Insurance Clauses of the People's Insurance Company of China (중국선박보험약관에 있어서 보험자의 보상책임에 관한 고찰)

  • 홍성화;마염추
    • Journal of the Korean Institute of Navigation
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    • v.25 no.4
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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.

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A Study on Exemption of Insurer for a Long Period Laid-up Fishing Vessel (장기 계류 어선에 대한 보험자의 면책에 관한 연구)

  • Park, Yong-Sub;Cha, Cheol-Pyo
    • Journal of Fisheries and Marine Sciences Education
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    • v.5 no.2
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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.

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ROBUST OPTIMAL PROPORTIONAL REINSURANCE AND INVESTMENT STRATEGY FOR AN INSURER WITH ORNSTEIN-UHLENBECK PROCESS

  • Ma, Jianjing;Wang, Guojing;Xing, Yongsheng
    • Bulletin of the Korean Mathematical Society
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    • v.56 no.6
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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.

Measuring the resource-based relative value scale scores for physical therapies of traditional Korean medicine and estimating the insurer's expenditure in National Health Insurance (한방물리요법 상대가치 산출과 급여 확대 시 재정부담 추계)

  • Lim, Byung-Mook;Shin, Mi-Sook;Shin, Byung-Cheul;Song, Yoon-Kyung;Song, Mi-Yeon;Shin, Seung-Woo;Kim, Ho-Jun;Lee, Myeong-Jong
    • Journal of Society of Preventive Korean Medicine
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    • v.14 no.2
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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.

A study on the problems about the obligation to notify in marine cargo insurance (해상적하보험에서 통지의무의 문제점에 관한 고찰)

  • Kim, Hee-Kil
    • THE INTERNATIONAL COMMERCE & LAW REVIEW
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    • v.46
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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.

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Problems and Solutions for Korean Medical Fee Contract System (건강보험 요양급여비용 계약의 문제점과 개선방안 연구)

  • Shin, Sung-Chul
    • Health Policy and Management
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    • v.19 no.1
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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.

A Study on Warranty in The Insurance Act 2015 (영국 2015년 보험법 상 담보(워런티)에 관한 연구)

  • SHIN, Gun-Hoon;LEE, Byung-Mun
    • THE INTERNATIONAL COMMERCE & LAW REVIEW
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    • v.73
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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.

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A Compartive Study on the Overseas Business Activity of Insurance Companies in Korea and Germany - a Case of German Legal Expenses Insurance Company - (한국 및 독일 보험회사의 해외 진출 모델 비교 연구 -독일 법률비용보험회사의 사례를 중심으로-)

  • Shin, Dong-Ho
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.11 no.8
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    • pp.2876-2881
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    • 2010
  • This paper attempts to find out implications based on the comparative analysis of overseas expansion model between the Korean insurance companies and the German one. There are three types of the strategies of the overseas-expansion-model of insurer, i.e. customer-oriented localized strategy, niche market-oriented strategy, and growing market-oriented strategy. From the review of related literatures and through an interview conducted by the insurance specialist, the findings are some differences between Korean and German insurance companies, when they go into foreign insurance markets. Th significant differences between Korean and German insurers are a customer oriented localized strategy and niche market oriented strategy. The Korean insurer shows a strength on the overseas-expansion-strategy, but the most clients of the Korean insurer on overseas markets are also Korean companies and Korean immigrants. The Korean legal expenses insurance market is yet in its embryonic stage, while the German legal expenses insurance company is pushing ahead with a strategy focused on localization and niche market on the legal expenses insurance product. In conclusion, like a case of the German legal expenses insurance company, the Korean insurer needs a customer oriented localized strategy as well as a niche market oriented strategy on the overseas insurance market.

Determinant Factors for Expenditure of the Medical Insurance Program for Self-Employeds (지역의료보험(地域醫療保險) 재정지출(財政支出)의 결정요인(決定要因))

  • Kam, Sin;Park, Jae-Yong;Yeh, Min-Hae
    • Journal of Preventive Medicine and Public Health
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    • v.28 no.1 s.49
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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.

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