• Korean Journal of Social Welfare
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• v.64 no.4
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• pp.359-381
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• 2012

This Study aims to investigate the patterns and causes of the time to return-to-work(RTW) of the injured workers. This study collected data with structured questionnaires and finally included 791 injured workers. The Kaplan-Meier method is used for describing the patterns of the time to RTW after the injury and after claim closure. And the Cox regression is used to identify significant factors on the time to RTW after the injury and after claim closure. The results show that amom the all respondents, the 2.65% returned to work within 1 month, 28.82% within 6 months, 50.95% within 1 year, 71.69% within 2 years after the injury, and the 29.46% of the all repondent returned to work before claim closure or directly after the claim closure, the 36.41% returned to work within 1 month, 56.64% within 6 months, 67.54% within 1 year after the claim closure. And the Cox regression results of the time to RTW after the injury show that the time to RTW affected by gender, age, income, the retirement during the treatment, the RTW to the company at injured time, injury type, surgery, the claim duration, disability ratings, vocational training. Also, the Cox regression results of the time to RTW after the claim show that the time to RTW affected by gender, age, income, the return to the company at injured time, disability ratings, vocational training. As a result, some implication and policies are suggested for reducing the time to RTW of the injured workers.

• Health Policy and Management
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• v.24 no.3
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• pp.261-270
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• 2014

Background: This study examined what factors affected a complete examination of infant health checkup. Methods: We used Korean national health insurance claim data of 2,936,650 infants, taking examination in 2012. These claim data included enrollment status of householders and records of infant health checkup from 2008 to 2013. Results: Our results shows that for infant characteristics, the likelihood of complete examination of infant health checkup is significantly lower in female, older aged, and handicapped ones. For householder characteristics, the likelihood of complete examination of infant health checkup is also significantly lower in female, older group and self-employed ones. For household characteristics, the likelihood of complete examination is also significantly lower in single-parent families, multi-cultural families, parent with unexperienced health checkup and lower monthly premiums. Conclusion: It is necessary to support an additional use-guide and follow-up management services to improve incomplete examination of infant health checkup.

• Explosives and Blasting
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• v.17 no.3
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• pp.13-22
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• 1999

It Is indispensible to cause vibration, noise and dust to blasting and breaker operations. Since the control of these factors is supposed to be extremely difficult, the claim of compensation for material and mental damages are getting increased. Economically feasible blasting operation with controlling vibration and noise can be achieved by establishment of science-based plan, accurate operation and responsible inspection, and the application of efficient management system. It must also be remarked that the relevant applied without prejudice by the operator, and the law and regulation should be applied without prejudice by the authority concerned. In addition, the public claim against operators should be investigated in detail and the prosecution should be made under the careful onside-ration of scientific and reasonable conception. Finally, it is strongly suggested that the operations, public and authorities should make great efforts to develop higher technology in order to expand our construction market, to overseas.

• International Journal of Computer Science & Network Security
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• v.22 no.2
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• pp.413-423
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• 2022

The NHIS provides free or highly subsidized healthcare to all people by providing financial fortification. However, the financial sustainability of the scheme is threatened by numerous factors. Therefore, this work sought to provide a solution to process claims intelligently. The provided Petri net model demonstrated successful data flow among the various participant. For efficiency, scalability, and performance two main subsystems were modelled and integrated - data input and claims processing subsystems. We provided smart claims processing algorithm that has a simple and efficient error detection method. The complexity of the main algorithm is good but that of the error detection is excellent when compared to literature. Performance indicates that the model output is reachable from input and the token delivery rate is promising.

• Journal of dental hygiene science
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• v.15 no.6
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• pp.815-824
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• 2015

This study aims to figure out the current state of health insurance education provided to dentists and personnel in charge of insurance claim as well as the effects of experiences in education on their knowledge of health insurance standard and actual application. As a result of analysis on 100 data sheets related to dentistry and 100 data sheets related to personnel in charge of insurance claim (a total of 200 data sheets), following results were generated. Insurance claim personnels showed higher score than dentist in knowledge of health insurance standard and it was significant statistically. Knowledge of insurance claim personnel showed significant differences in educational experiences, in health insurance for the latest three years and average hours of education per session whereas that of dentists did not indicate any significant differences. The level of practical application of dentists was significantly different (p<0.05) according to experiences in insurance claim, and that of insurance claim personnel significantly varied (p<0.05) depending on age, experiences of insurance education and average hours of education. The longer average hours of education, the higher level of practical application. Experiences of insurance education turned out to affect on the knowledge of health insurance standard significantly (p<0.05) on the part of dentists and insurance claim personnel, and the level of experiences in insurance claim and knowledge of health insurance standard on the part of dentists and insurance claim personnel turned out to affect on practical application significantly (p<0.001). Judging from the result, continuous education needs to be conducted in order to enable dentists and insurance claim personnel to maintain the level of knowledge about health insurance and practical application.

• Proceedings of the Korean Institute of Building Construction Conference
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• 2006.05a
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• pp.125-128
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• 2006

Since the diversification, complication of the construction industry, construction conflicts have been increased these days. Expansion of scale of construction has brought conflict treatment cost increase. Thus, needs of the study on construction conflict risk factors and its management is getting important. But the existing studies about construction conflicts and risk factors that need to be cared to decrease construction cost are almost focused on analysis of number of conflict proposed. It means those studies can be helpful when want to know how many conflict have been instituted, however, they do not contain a close examination between types of conflict and cost of conflict treatment. The purpose of this study, therefore, is an extraction of conflict causes based on the conflict treatment cost and the choice of significant risk factors to be managed to prevent conflict and its treatment cost, which enables reducing the conflict treatment colt on control the risk factors.

• The Korean Journal of Health Service Management
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• v.9 no.4
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• pp.183-196
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• 2015

Objectives : The purpose of this study was to analyze the factors affecting the level of subjective health recovery among injured workers. The aim in this study was to find an efficient worker's compensation service for subjective health recovery among injured workers. Methods : From the 1st panel study of worker's compensation insurance, data for 2,000 injured workers was analyzed with SPSS 22.0 and AMOS 22.0. Results : There was a statistically significant difference in the level of self-perceived health recovery depending on socio-demographic characteristics, disability characteristics and medical care services. Factors such as gender, education level, socio-economic level, disability level, claim duration, and treatment duration appropriacy affected the level of self-perceived health recovery. Conclusions : Worker's compensation services should take into consideration the factors that affect the health recovery of injured workers.

• Proceedings of the KSR Conference
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• 2007.11a
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• pp.558-563
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• 2007

Walking passenger injury accidents in and around stations have increased in recent years, and passengers are now more aware of being able to claim compensation for such accidents. Therefore, it is anticipated that station managers and owners will need to take measures to improve the condition of walking areas so that performance objectives are met an the compensation paid for passenger accidents is limited. The aim of this study covers the following: accidents statics and contributory factors, station flooring and footway material, guidance for flooring, and test methods for slipperiness and surface profile.

• Journal of the Korean housing association
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• v.27 no.5
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• pp.65-72
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• 2016

The purpose of the study was to investigate defect cases in residential interior design, to identify the state of defects, and to categorize types of defect and disputes. In addition, consumer appraisal to residential interior design service were analyzed. The results of this study could provide fundamental information regarding the defects and claims in residential interior design. First, we did literature review for defect disputes in architectural design and interior design. We identify the definition of defects by building life cycle, by state of construction, by activity, and by design performance. Second, we analysed interior design defects cases reported in Korea Consumer Agency & Ministry of Land, Infrastructure and Transport. A total of 49 cases of defect disputes in residential interior design from 2000 to 2015 were investigated. As a result, many defects appeared during the construction stage. A majority of defects cases fall into insulation, water-proofing/leakage work. In terms of design aspects claim, functional and aesthetic defects were claimed. Third, from Consumer Market Evaluation Indicators, raw data from 500 respondents were investigated for the housing repair and interior design. It is found that information comparability, responsiveness to consumer claim, price, and safety are important factors for consumer satisfaction in interior design.

• The Journal of the Korean life insurance medical association
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• v.26
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• pp.31-39
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• 2007

Background and main issue: In the Korean insurance market, an outstanding issue is the decrease of margin of risk ratio. This affects the solvency and profitability of insurance companies. Insurance medicine, which has been developed in Western countries, is so-called medical risk selection or medical underwriting. Medical risk selection is based on clinical follow-up study and mortality analysis methodology. Unfortunately, there have been few clinical follow-up studies, and no intercompany disease analysis system is available in the Korean insurance market. In practice, we use underwriting guidelines, which were developed by some global reinsurance companies. However, these guidelines were developed under clinical follow-up studies performed abroad. So, we cannot rule out underestimation of excess mortality factors such as mortality ratio, excess death rate, and life expectancy. It is necessary to perform medical assessment in claims administration. Comparing the insured's statement by medical records with products' benefit according to this procedure, we can make sound claim decisions and participate in the role of sound underwriting. We can call this scientific procedure as the verification of medical claims review. Another area of medical claims review is medical counsel for claims staff. Result: There is another insurance medicine in addition to medical risk selection. Independent medical assessment by medical records of insured is medical claims review. Medical claims review is composed of verification and counsel.