• Title/Summary/Keyword: Insurer

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Review of Programs for Improving Patient's Access to Medicines (의약품 접근성 향상을 위한 방안 고찰)

  • Kim, EuGene;Kim, Younhee
    • Korean Journal of Clinical Pharmacy
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    • v.28 no.1
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    • pp.40-50
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    • 2018
  • Objective: This study presented the analysis period, the complexity of combined therapy and comparator choice as the key limitations in the economic evaluation of new drugs, and discussed programs for coping with these limitations. Methods: This study evaluated the post-evaluation, risk-sharing agreement, extra funding program, and flexible incremental cost-effectiveness ratio (ICER) threshold as actions or programs that would increase accessibility to costly new drugs. The study also presented the cases of other countries. The application of the post-evaluation was considered to deal with high uncertainty regarding new drugs. Results: The risk-sharing agreement was introduced in European countries as well as South Korea and has been responsible for the shift from using the financial schemes to outcome-based schemes. The drug funding program has had troubled in securing stable extra funds. The application of higher ICER in the economic evaluation of expensive and innovative oncology drugs was criticized because of the inequity between oncology patients and patients with other diseases. Conclusion: Therefore, introducing and applying actions that would increase the accessibility to costly new drugs in South Korea have been deemed necessary after careful reviews and discussions with various stakeholders (insurer, policy makers, pharmaceutical companies and patients).

An Increase the South-North Economic Corporations and Insurance as a Scheme for the Transfer of Risk - Focus on the Source of North Korea Insurance Law - (남북경협증가에 따른 위험의 완화방법으로서의 보험제도 - 북한보험법의 법원문제를 중심으로 -)

  • Kim Sun-Jeong
    • Journal of Arbitration Studies
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    • v.15 no.3
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    • pp.267-301
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    • 2005
  • Following the increased economic corporations between the South and North Korea, many companies participate the corporation program. They needs insurance policy as a scheme for the transfer of risk from those individual company to it to an insurer. This paper review the possibility of the North Korea insurance authorities and research the origin, history, structure and context of the North Korea insurance law. The North Korea Insurance law differ from the South Korea and China's. North Korea Insurance authority has not capability of doing insurance business both side of underwriting and indemnity. Partly, it caused the uncertainty, insufficient and vague of the insurance law. The writer conclude that the North Korea insurance law faced to the needs of modernization. Especially, the Gyesung Industrial Complex Insurance Regulation couldn't cover the investor and company's risk because it is not based on the nature and basic principles of insurance.

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A Study on the Clauses of Insurance Contracts on Incoterms(R) 2010 (Incoterms(R) 2010의 보험계약조항에 관한 고찰)

  • Kim, Hee-Kil
    • THE INTERNATIONAL COMMERCE & LAW REVIEW
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    • v.53
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    • pp.135-153
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    • 2012
  • Incoterms is a standard transaction terms and conditions which is established to provide goods delivery, cost and risks between the seller and the buyer as a principle concerned. Incoterms is made of international rules about regular uses of transaction terms and condition. It removes uncertainty of misunderstanding and applying rules, commercial customs and etc, between nations. Incoterms does not have an enforcement like an unified rules or an agreements established between different nations. Therefore, it is just considered as a standard formal terms and conditions from International Chamber of Commerce. For those reasons, validity of Incoterms applies only when parties of contract come to an agreement not by officially adopted or applied by law in each nation. Incoterms 2010 contains specific and clear articles which is fixed version of incoterms 2000, it has insufficient points on insurance contract article. Though, insurance contract belongs to sales contract, it sustains independence itself. It is difficult to sustain perfection until establishment of insurance contract and expiration by fixing the articles. As a result, it is necessary for sellers and buyers take a full responsibility of making complete insurance contract. This paper is written for those reasons in this filed.

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A study on the reinforcing competitiveness plan for insurer from PB market (PB 시장에서의 보험사 경쟁력 강화방안 연구)

  • Kwak, Bong-Hwan;Ham, Young-Jin
    • International Commerce and Information Review
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    • v.9 no.2
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    • pp.41-64
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    • 2007
  • A life insurance industry's market is reaching a state of saturation recently, and the competition is as time goes by intense among the non-life insurance industry. Consequently, the insurance companies must grope a new source of revenue and develop a new business model for a stability growth. At the forked road, the insurance companies must group the existing and new customers in order to find the royal customers, and develop a new service with them. Accordingly, it is the time to study the advance of PB field and the royal customer management that will maintain and expand the new relations with them. Besides, the PB was the service to begin in needs of the specific group, but now it is regarded as a new source of high profit in the age of universal financial service among the financial circles. As a consequence, the PB marketing is introduced in haste, and such trend seems to be continued. Therefore, the plans that help the domestic insurance company reflect the characteristic of the insurance and expand the scope of business into the scope of property management according to the needs of customers under a universal financial service trend will be studied.

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A Comparative Study of Solvency Margin Regulation System : Focusing on Non-Life Insurance (지급여력제도의 국제적 정합성 연구 - 손해보험을 중심으로 -)

  • Jung, Hong-Joo;Nam, Sang-Wook;Park, Heung-Chan;Lee, Jae-Seok
    • THE INTERNATIONAL COMMERCE & LAW REVIEW
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    • v.17
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    • pp.93-125
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    • 2002
  • This paper aims to find a reasonable solvency margin system in non-life insurance industry and also to evaluate the appropriateness of the current solvency margin regulation system in Korea. The current solvency margin system in Korea, based on EU's solvency margin model, was introduced during the 1997 financial crisis. The solvency requirement is not based on non-life insurer's risk, but simply on written premiums. The current solvency margin for general insurance, such as fire, marine, and automobile insurance, is determined by the greater between a premium-based amount and a claim-based amount, where the premium-based solvency margin is calculated by multiplying the net written premium for the preceding year by the premium based solvency margin ratio. Also, the amount of solvency margin for long term insurance is set at 4% of the policy reserve of the long term insurance. Still, there exist many differences between the current solvency margin regulation system in Korea and EU's model. This paper focuses on the rationality of the solvency margin regulation system, and compares the current system in Korea with EU's model and the RBC(Risk Based Capital) system in U.S. and Japan. Finally, this paper suggests a more specific and reasonable solvency margin system to be developed in Korea.

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The Effect of Aerated Concrete containing Foam Glass Aggregate on the Floor Impact Sound Insulation (발포유리 혼합기포 콘크리트의 바닥충격음 차단성능 영향에 관한 연구)

  • Yun, Chang-Yeon;Jeong, Jeong-Ho;Kim, Myung-Jun
    • Transactions of the Korean Society for Noise and Vibration Engineering
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    • v.23 no.5
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    • pp.414-422
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    • 2013
  • As structure-borne sound, the floor impact sound is one of the serious noises in residential building. Most of heating system applied to the typical Korean residential building is floor heating system which is called ondol. The ondol usually consists of finishing material, mortar with heating coil, light-weight aerated concrete and reinforced concrete. This study focused on the isolation of heavy-weight impact sound and modification of mortar and light-weight aerated concrete. Specifically the glass foam aggregate was added on light-weight aerated concrete. Also, water-cement ratio and amount of cement on mortar were revised. The sound pressure level of heavy-weight impact was measured in reverberation chamber using both bang-machine and impact ball. The size of specimen was 1 m by 1 m. Substitution ratio of glass foam aggregate on light-weight aerated concrete shows relationship with heavy-weight impact sound pressure level. In addition, heavy-weight impact sound pressure level was decreased with increment of water-cement ratio and amount of cement on mortar.

Comparison Actual Conversion Factor with Estimated Conversion Factor by Fee Adjustment Model Reflecting Health Service Volume (서비스양을 고려한 수가 결정모형에 의한 추정 환산지수와 실제 환산지수의 비교)

  • Han, Ki Myoung;Cho, Min Ho;Lee, Soo Jin;Chun, Ki Hong
    • Health Policy and Management
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    • v.23 no.4
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    • pp.343-348
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    • 2013
  • Background: Price control alone may not successfully restrain growth in health expenditures. This study aimed to propose fee adjustment model suitable for Korea reflecting health service volume and to clarify applicability of the model by comparing actual conversion factor with estimated conversion factor from simulation of this model. Methods: Fee adjustment model was developed based on Alberta's fee adjustment formula in Canada and 7 alternatives were assessed according to diversely applied parameters of the model. Results: Estimated conversion factors of the tertiary care hospital and the hospital were lower than actual conversion factors, since the utilization of heath service has been increased. However, there was no big difference between estimated conversion factors and actual conversion factors of the general hospital and the clinic. Eventually this fee adjustment model could estimate proper conversion factor reflecting health service volume. Conclusion: This model may be applicable to the mechanism as determining conversion factor between insurer and provider via negotiation and controling growth in health expenditures.

Trends and its Policy Implications of Copayment System on Office-Based Medical Care during the Last Decade in Korea (의원 외래 본인부담정액제의 변천과 정책적 함의)

  • 김창보;이상이
    • Health Policy and Management
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    • v.11 no.4
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    • pp.1-20
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    • 2001
  • Korean government had introduced copayment system as cost sharing to office-based medical care in order to reduce the demand for care in 1986. This review focuses on trends and characteristics of copayment on office-based medical care from 1991 to the end of Jan. 2001. Objectives of this study is ${\circled}1$ to analyse historical trends of copayment on office-based medical care during the last decade, ${\circled}2$ to analyse the effect of copayment introduced to office-based medical care on NHI finance, ${\circled}3$ to analyse the changing trends of the size of copayment in utilizing office-based medical care for the past 10 years, ${\circled}4$ to evaluate the meaning of copayment alteration implemented after the introduction of new prescription system and finally ${\circled}5$ to draw a some policy implications from the results of this review. We found that the main purpose of copayment introduction had been reduction in the expenditure of NHI finance. But, the reduction effect of insurer's expenditure has turned out to be negative and NHI finance has been in crisis after the introduction of new prescription system. Also, the copayment level of the insured has increased actually on a large scale. It seems that the introduction of new prescription system has changed the meanings and its policy implications of copayment system.

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EC's Recent Developments of Legal Regime in Governing Law for Marine Insurance Contracts (유럽연합 법제상 해상보험계약의 준거법에 관한 연구)

  • Lee, Ju-Young;Park, Won-Hyung
    • The Journal of Fisheries Business Administration
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    • v.43 no.1
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    • pp.63-74
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    • 2012
  • The Korean Conflict of Laws Act recently incorporated much of the European Union's recent revision in "EC Convention on the Law Applicable to Contractual Obligations (Rome 1980)"(hereinafter Rome Convention). With the revision of Rome Convention applied to contractual obligations,"Regulation (EC) No 593/2008 of the European Parliament and of the Council of 17 June 2008 on the law applicable to contractual obligations (Rome I)"(hereinafter Rome I) has taken effect on December 2009. Before the effectivation of Rome I, "Regulation (EC) No 864/2007 of the European Parliament and of the Council of 11 July 2007 on the law applicable to non-contractual obligations (Rome II)"(hereinafter Rome II) has come into effect on January 2009. This means the revision of certain rules and its practical implications need an in-depth study on governing law rules under Rome I which provides newly effected governing laws applicable to contractual obligations. Moreover, uniform choice of law rules on non-contractual obligations needs to focus especially on marine insurance contract. Where policy assignment and subrogation causes, how to decide the governing law which will be applied to the insurer as a third party? This article attempts to analyze emerging legal issues in legal regimes determining choice of law, especially those in international marine insurance contracts. This will help Korean practitioners to be dialed in legal affairs under English Law as the governing law in their contracts.

An Overview of the Risk Sharing Management in Korean National Health Insurance, Focused on the Effect of the Patient Access and Insurance Finance (우리나라 건강보험의 위험분담제도가 재정 및 환자접근성에 미친 영향)

  • Lee, Jong Hyuk;Bang, Joon Seok
    • Korean Journal of Clinical Pharmacy
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    • v.28 no.2
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    • pp.124-130
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    • 2018
  • Objective: This study examined the Risk Sharing Agreement (RSA) on pharmaceutical pricing system in Korean national health insurance. Through RSA, the insurer was able to maintain the principles in the price listing process while managing the budget effectively and improving patient access to new drugs. Despite these positive effects, there are still issues raised by some stakeholders, such as lack of transparency in the listing process and doubts about its effectiveness. Therefore, we investigated the impacts of RSA on national health insurance financing and patient access to analyze the effects of RSA. Methods: The impact of RSA was investigated by analyzing the health insurance claims data for 2014~2016. The degree of improvement in patient access was determined by the decreased amount of patients' payment. Results: Results showed that the financial impact of RSA was not significant and patients' access to the new drug greatly improved. Conclusion: These results show that RSA is a good system for improving patient access to new drugs without additional expense on insurance.