• Proceedings of the Korean Institute of Building Construction Conference
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• 2002.11a
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• pp.111-116
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• 2002

The delay of the completion of the construction project occurs frequently because the origin schedule is affected by numerous factors that contribute to the overall delay in completing the project. But in our country. the dealing with a claim is not sufficient yet by reasons of fairl relation between owner and constructor, cognitive shortage in claim, and such. especially they have make a wrong application of baseless the rule. In this study. we make a rational model ; that includes calculating of dispute costs, and suggest the solution and the prevention for claim by considerating the law followed liquidated damages.

• Journal of Preventive Medicine and Public Health
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• v.22 no.2 s.26
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• pp.259-267
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• 1989

The objective of this study was to analyze the influence of the hospital and insurer in causing delayed reimbursement of medical insurance benefits. We analyzed major variables at three different sized hospitals to examine the effect of the hospital and insurer using the two-way ANOVA method. The results were as follows: 1. The time interval between claim by hospitals and payment of the benefit was statistically different according to hospital in both admission and outpatient care. 2. The time needed by the insurer for investigating the claims was statistically different according to hospital and insurer in both admission and outpatient care. There was interaction between the hospital and insurer factors in outpatient care. 3. Although there was interaction between the hospital and insurer factors in admission care, the time interval between claim and payment was statistically different. In outpatient care, the payment interval between claim and payment was also statistically different according to the hospital and insurer.

• Journal of Fashion Business
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• v.26 no.6
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• pp.82-93
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• 2022

Sustainability is a significant change that fashion industry has undergone. Marketers and brands are looking for guidance in green advertising to most effectively motivate consumers to purchase sustainable fashion products. This study aims to reveal environmental and cultural sustainability claims on message credibility and purchase intention regarding product trendiness. We performed mediation and moderation analyses, using a 2 (sustainability message: environmental and cultural) × 2 (product design: classic vs. trendy) between-subjects experimental design. The PROCESS MACRO was used for the analysis. Results indicate that environmental claim must appear credible to consumers to motivate them to purchase a product. On the other hand, cultural claim, with and without credibility, affected consumer's purchase intention. Moreover, cultural claim and trendy design together influenced message credibility and purchase intention, showing a moderated mediation effect. The study indicates that brands should broaden their perspective regarding sustainability by considering cultural factors when providing sustainability claims. Environmental claim should be clear and transparent to avoid green skepticism. Also, it is important to focus on product's design aspect: making trendy designs. It is difficult to change consumer behavior based only on sustainability value. Thus, brands must coney their consideration of design trends. Theoretical and managerial implications also are discussed.

• Korea Journal of Hospital Management
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• v.9 no.3
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• pp.71-97
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• 2004

This study conducted a comparative analysis of awareness level of review standards, continuing education, and awareness about the need for speciality and educational courses in order to improve quality of Korean health insurance review work and to present directions for policies of personnel development and continuing education to smoothly perform hospital's insurance claim work and Agency's review work. The analysis unit of the study is individuals, and survey was conducted among hospital's claim officers and Agency' review officers by distributing questionnaires. The major results of the study are as follows: First, it is found that hospital's claim officers and Agency's review officers have conflicting awareness about review standards; more Agency's review officers think that current review standards are universal and reasonable, while more hospital's claim officers believe that they need to be revised. Especially, hospital's claim officers replied that it is possible that review results can differ according to government's policies. Second, there is no significant difference between the two groups in the opinion that there are individual differences in awareness level of review standard. In particular, both groups share the opinion that review results can differ according to officer's interpretation of review standards. Third, Both review officer groups feel the need for further training and continuing education. Fourth, there is no difference between the two groups in the opinion that both groups members should be educated in review related educational institutions. However, while 81.5% of Agency's review officers the education should be offered at the Agency, only 45.2% of hospital's claim officers agreed to it. Fifth, both review personnel do not show any difference in awareness of needed experience to successfully perform review work; both groups replied that three to four years experience is necessary to smoothly perform claim work and review work. This study was tried in order to search for directions to improve Korean insurance review work in quality rather than to explore characteristics themselves of individual factors. In this sense, this study presupposed an intention that the educational subjects for further training and continuing education for the two groups should be the same in order to narrow the awareness gap between hospital's claim officers and Agency's review officers. Thus, this study suggests that it is desirable to offer beginner courses at junior colleges or in undergraduate courses and advanced courses in professional graduate school for six to twelve months. In that a comparison of awareness level of hospital's claim officers and Agency's review officers who are actually in practice should precede appropriate presentation of directions for the qualitative improvement of insurance review work in Korea, the significance of this study lies in comparatively analyzing the awareness level of hospital's claim officers and Agency's review officers and in presenting the establishment of future further training and continuing education.

• Proceedings of the Korean Institute Of Construction Engineering and Management
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• 2006.11a
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• pp.301-304
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• 2006

The insistence of rights and interests in contract is being generalized by opening in construction market which is following F.T.A, internationally. Conditions of contract in construction have different specialities compared with other industries. Different conditions of contract should be established because of a specific character that is different from each construction, such as work, environment, circumference conditions. Although the order of Turn-key is being expanded by increasing construction scale and demanding hybrid function, the suitable regulations of contract are not settled. As a result, various factors of claim is occurring in Change Order-Claim, because they just obey a part of guide-line. This study suggests useful solutions in detail concerned with the main factor of Change Order-Claim by each D/B phases through practical sorting and analysis of the causes of Change Order-Claim.

• International conference on construction engineering and project management
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• 2015.10a
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• pp.710-711
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• 2015

A nuclear power plant construction is a complex form of construction which comprises various stakeholders and contractors. Therefore, contract disputes will occur due to conflicting interests of contracting parties and unpredictable factors which arise during construction work. Even if the contract is well prepared, it cannot fully prepare for future situations in actuality. Claims management is very important in carrying out construction management. This study intends to define claim, and delve into development of claims management processes from the viewpoint of owners and contractor through consideration on international contract terms on claims management and the details of the claims management of the Construction Extension to the PMBOK. In addition, it is needed to accumulate and manage data on claims that have occurred so that they can be referenced in the future. As information should be accumulated so that type classification can be carried out and that lessons can be learned on claims that have occurred in each business site, study on establishing data-based systems relating to claims processes will be needed in the future.

• Health Policy and Management
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• v.26 no.1
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• pp.71-78
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• 2016

The value of using health insurance claim database is continuously rising in healthcare research. In studies where comorbidities act as a confounder, comorbidity adjustment holds importance. Yet researchers are faced with a myriad of options without sufficient information on how to appropriately adjust comorbidity. The purpose of this study is to assist in selecting an appropriate index, look back period, and data range for comorbidity adjustment. No consensus has been formed regarding the appropriate index, look back period and data range in comorbidity adjustment. This study recommends the Charlson comorbidity index be selected when predicting the outcome such as mortality, and the Elixhauser's comorbidity measures be selected when analyzing the relations between various comorbidities and outcomes. A longer look back period and inclusion of all diagnoses of both inpatient and outpatient data led to increased prevalence of comorbidities, but contributed little to model performance. Limited data range, such as the inclusion of primary diagnoses only, may complement limitations of the health insurance claim database, but could miss important comorbidities. This study suggests that all diagnoses of both inpatients and outpatients data, excluding rule-out diagnosis, be observed for at least 1 year look back period prior to the index date. The comorbidity index, look back period, and data range must be considered for comorbidity adjustment. To provide better guidance to researchers, follow-up studies should be conducted using the three factors based on specific diseases and surgeries.

• THE INTERNATIONAL COMMERCE & LAW REVIEW
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• v.76
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• pp.125-145
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• 2017

Where an insurer has unreasonably refused to pay a claim or paid it after unreasonably delay, the existing law in England does not provide a remedy for the insured. Accordingly, the insured is not entitled to damages for any loss suffered as a result of the insurer's unreasonable delay. This legal position differs from the law in Scotland and most major common law jurisdictions. LC thought that the legal position in England is anomalous and out of step with general contractual principles. LC considered that a policyholder should have a remedy where an insurer has acted unreasonably in delaying or refusing payment of claim, and, therefore, recommended a statutory implied term in every insurance that the insurer will pay sums due within a reasonable time and breach of that term should give rise to contractual remedies, including damages. More detailed recommendations of LC are as followings. First, it should be an implied term of every insurance contract that, where an insured makes a claim under the contract, the insurer must pay sums due within a reasonable time. Secondly, a reasonable time should always include a reasonable time for investigating and assessing a claim. Although a reasonable time will depend on all the relevant circumstances, for example, the following things may need to be taken into account, that is, (1) the type of insurance, (2) the size and complexity of the claim, (3) compliance with any relevant statutory rules or guidance, and (4) factors outside the insurer's control. Thirdly, if the insurer can show that it had reasonable grounds for disputing the claim(whether as to pay or not, or the amount payable), the insurer does not breach the obligation to pay within a reasonable time merely by failing to pay the claim while the dispute is continuing. In those circumstances, the conduct of the insurer in handling the dispute may be a relevant factor in deciding whether the obligation was breached and, if so, when. Fourthly, Normal contractual remedies for breach of contract should be available for breach of the implied term to pay sums due within a reasonable time. Finally, In non-consumer insurance contracts, the insurer should be permitted to exclude or limit its liability for breach of the obligation to pay sums due within a reasonable time, unless such breach was deliberate or reckless, and such an insurer's right to contract out will be subject to satisfying the transparency requirements.

• 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.

• Knowledge Management Research
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• v.22 no.1
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• pp.57-84
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• 2021

In this paper, we explore market and environmental factors which affecting organization's priority claim application which is more powerful and prompt strategic method to protect technology from competitors under uncertain and volatile environments. This study empirically examines why organizations strategically choose the priority claim application which is more strong tactics to protect technology as the source of sustainable competitive advantage. We suggest that market and environmental factors, such as exogenous shock, volatility, and uncertainty, may also affect strategic decision that organization take patent application with claiming priority. The results of our analysis of priority claim application in the Korean high-tech electronics industry from 1994 to 2008 showed that these three strategic factors affected the technology protection decision and organization's status also moderate theses effects, as predicted in our hypotheses.