• 제목/요약/키워드: compensation claim

검색결과 90건 처리시간 0.021초

인신사고로 인한 손해배상과 보험자의 구상권 - 국민건강보험공단의 구상권을 중심으로 - (Compensation for Personal Injury and the Insurer's Claim for Indemnity - Focused on the NHIC's Claim for Indemnity -)

  • 노태헌
    • 의료법학
    • /
    • 제16권2호
    • /
    • pp.87-130
    • /
    • 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.

  • PDF

Occupational Injuries Among Construction Workers by Age and Related Economic Loss: Findings From Ohio Workers' Compensation, USA: 2007-2017

  • Harpriya Kaur;Steven J. Wurzelbacher;P. Tim Bushnell;Stephen Bertke;Alysha R. Meyers;James W. Grosch;Steven J. Naber;Michael Lampl
    • Safety and Health at Work
    • /
    • 제14권4호
    • /
    • pp.406-414
    • /
    • 2023
  • Background: This study examined age-group differences in the rate, severity, and cost of injuries among construction workers to support evidence-based worker safety and health interventions in the construction industry. Methods: Ohio workers' compensation claims for construction workers were used to estimate claim rates and costs by age group. We analyzed claims data auto-coded into five event/exposure categories: transportation incidents; slips, trips, and falls (STFs); exposure to harmful substances and environments; contact with objects and equipment (COB); overexertion and bodily reaction. American Community Survey data were used to determine the percentage of workers in each age group. Results: From 2007-2017, among 72,416 accepted injury claims for ~166,000 construction full-time equivalent (FTE) per year, nearly half were caused by COB, followed by STFs (20%) and overexertion (20%). Claim rates related to COB and exposure to harmful substances and environments were highest among those 18-24 years old, with claim rates of 313.5 and 25.9 per 10,000 FTE, respectively. STFs increased with age, with the highest claim rates for those 55-64 years old (94.2 claims per 10,000 FTE). Overexertion claim rates increased and then declined with age, with the highest claim rate for those 35-44 years old (87.3 per 10,000 FTE). While younger workers had higher injury rates, older workers had higher proportions of lost-time claims and higher costs per claim. The total cost per FTE was highest for those 45-54 years old ($1,122 per FTE). Conclusion: The variation in rates of injury types by age suggests that age-specific prevention strategies may be useful.

Covid-19 Occupational Risk Incidence and Working Sectors Involved During the Pandemic in Italy

  • Fabio Boccuni;Bruna M. Rondinone;Giuliana Buresti;Adelina Brusco;Andrea Bucciarelli;Silvia D'Amario;Benedetta Persechino;Sergio Iavicoli;Alessandro Marinaccio
    • Safety and Health at Work
    • /
    • 제14권4호
    • /
    • pp.398-405
    • /
    • 2023
  • Background: Starting from March 2020 until December 2021, different phases of Covid-19 pandemic have been identified in Italy, with several containing/lifting measures progressively enforced by the National government. In the present study, we investigate the change in occupational risk during the subsequent pandemic phases and we propose an estimate of the incidence of the cases by economic sector, based on the analysis of insurance claims for compensation for Covid-19. Methods: Covid-19 epidemiological data available for the general population and injury claims of workers covered by the Italian public insurance system in 2020-2021 were analyzed. Monthly Incidence Rate of Covid-19 compensation claims per 100,000 workers (MIRw) was calculated by the economic sector and compared with the same indicator for general population in different pandemic periods. Results: The distribution of Covid-19 MIRw by sector significantly changed during the pandemic related to both the strength of different waves and the mitigation/lifting strategies enforced. The level of occupational fraction was very high at the beginning phase of the pandemic, decreasing to 5% at the end of 2021. Healthcare and related services were continuously hit but the incidence was significantly decreasing in 2021 in all sectors, except for postal and courier activities in transportation and storage enterprises. Conclusion: The analysis of compensation claim data allowed to identify time trends for infection risk in different working sectors. The claim rates were highest for human health and social work activities but the distribution of risk among sectors was clearly influenced by the different stages of the pandemic.

손해사정회사 종업원의 직장만족 결정요인 연구 (A empirical study on the Employee's Workplace Satisfaction for Insurance Claim adjusting company)

  • Kim, Jaetae;Yoo, kyungjin;Choi, Youngjin;Kim, Jongwon
    • 한국재난정보학회 논문집
    • /
    • 제11권2호
    • /
    • pp.245-252
    • /
    • 2015
  • 태풍 등 재난발생 시에 손해액을 평가하는 손해사정회사 종업원들의 직장만족은 손해평가업무에 영향을 미치며 종국적으로는 피해자의 보상만족에 영향에 미치게 된다. 따라서 종업원의 직장만족은 재난피해자의 보상만족에 영향을 미치는 요인 중 하나이다. 본 연구는 손해사정회사 종업원의 직장만족 결정요인에 대한 실증연구로 연구결과는 종업원들의 심리차원의 요인, 조직차원의 요인 및 개인차원의 요인이 종업원들의 직장만족에 통계적으로 유의하게 영향을 미치는 것으로 나타났다. 그중에서 심리차원의 요인이 가장 크게 영향을 미치고, 다음으로 조직차원의 요인과 개인차원의 요인이 비슷한 크기로 영향을 미치는 것으로 나타났다. 인지차원의 요인은 종업원의 직장만족에 통계적으로 유의하지 않은 것으로 나타났다. 손해사정회사들은 종업원직장만족의 향상을 위하여 이러한 연구결과를 활용할 수 있을 것이다.

공기지연에 따른 클레임 대응방안에 관한 연구 - 지체상금을 중심으로 - (A Study on a System of Resolving Claim according to the Delay of Construction Projects - Focus on Liquidated Damages -)

  • 이영민;이상범;김정길
    • 한국건축시공학회:학술대회논문집
    • /
    • 한국건축시공학회 2002년도 학술.기술논문발표회
    • /
    • pp.111-116
    • /
    • 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.

  • PDF

A Basic Study on the Introduction of Professional Indemnity Insurance for Construction Project Managers

  • Cho, Young-Jun
    • 한국건축시공학회지
    • /
    • 제13권2호
    • /
    • pp.102-111
    • /
    • 2013
  • During the administration of a construction project, various types of participants are engaged in the project. From the design phase to the maintenance phase, these participants may confront many risks. To avoid these risks, participants should utilize an insurance company or a bond company. The types of risks and liability that a construction manager may face are listed in the construction law or contract. But there are some arguments related to risk transferring and the content of risks. For this reason, construction managers must carefully consider any possible risks in the contract and the construction law. Therefore, for construction managers to deal with risks appropriately, the introduction of a legal requirement to carry professional liability insurance, a defined compensation range for damages, a method of guarantee in the event of defects, a defined compensation claim period for damage, and a method of damage claim were suggested in this study.

우주법상 손해배상책임과 분쟁해결제도 (The Liability for Damage and Dispute Settlement Mechanism under the Space Law)

  • 이강빈
    • 한국중재학회지:중재연구
    • /
    • 제20권2호
    • /
    • pp.173-198
    • /
    • 2010
  • The purpose of this paper is to research on the liability for the space damage and the settlement of the dispute with reference to the space activity under the international space treaty and national space law of Korea. The United Nations has adopted five treaties relating to the space activity as follows: The Outer Space Treaty of 1967, the Rescue and Return Agreement of 1968, the Liability Convention of 1972, the Registration Convention of 1974, and the Moon Treaty of 1979. All five treaties have come into force. Korea has ratified above four treaties except the Moon Treaty. Korea has enacted three national legislations relating to space development as follows: Aerospace Industry Development Promotion Act of 1987, Outer Space Development Promotion Act of 2005, Outer Space Damage Compensation Act of 2008. The Outer Space Treaty of 1967 regulates the international responsibility for national activities in outer space, the national tort liability for damage by space launching object, the national measures for dispute prevention and international consultation in the exploration and use of outer space, the joint resolution of practical questions by international inter-governmental organizations in the exploration and use of outer space. The Liability Convention of 1972 regulates the absolute liability by a launching state, the faulty liability by a launching state, the joint and several liability by a launching state, the person claiming for compensation, the claim method for compensation, the claim period of compensation, the claim for compensation and local remedy, the compensation amount for damage by a launching state, the establishment of the Claims Commission. The Outer Space Damage Compensation Act of 2008 in Korea regulates the definition of space damage, the relation of the Outer Space Damage Compensation Act and the international treaty, the non-faulty liability for damage by a launching person, the concentration of liability and recourse by a launching person, the exclusion of application of the Product Liability Act, the limit amount of the liability for damage by a launching person, the cover of the liability insurance by a launching person, the measures and assistance by the government in case of occurring the space damage, the exercise period of the claim right of compensation for damage. The Liability Convention of 1972 should be improved as follows: the problem in respect of the claimer of compensation for damage, the problem in respect of the efficiency of decision by the Claims Commission. The Outer Space Damage Compensation Act of 2008 in Korea should be improved as follows: the inclusion of indirect damage into the definition of space damage, the change of currency unit of the limit amount of liability for damage, the establishment of joint and several liability and recourse right for damage by space joint launching person, the establishment of the Space Damage Compensation Review Commission. The 1998 Final Draft Convention on the Settlement of Disputes Related to Space Activities of 1998 by ILA regulates the binding procedure and non-binding settlement procedure for the disputes in respect of space activity. The non-binding procedure regulates the negotiation or the peaceful means and compromise for dispute settlement. The binding procedure regulates the choice of a means among the following means: International Space Law Court if it will be established, International Court of Justice, and Arbitration Court. The above final Draft Convention by ILA will be a model for the innovative development in respect of the peaceful settlement of disputes with reference to space activity and will be useful for establishing the frame of practicable dispute settlement. Korea has built the space center at Oinarodo, Goheung Province in June 2009. Korea has launched the first small launch vehicle KSLV-1 at the Naro Space Center in August 2009 and June 2010. In Korea, it will be the possibility to be occurred the problems relating to the international responsibility and dispute settlement, and the liability for space damage in the course of space activity. Accordingly the Korean government and launching organization should make the legal and systematic policy to cope with such problems.

  • PDF

우주활동에 의하여 발생한 손해배상책임에 관한 연구 - 관련 사례를 중심으로 - (A Study on the Liability for Damage caused by Space Activity - With reference to Relevant Cases -)

  • 이강빈
    • 항공우주정책ㆍ법학회지
    • /
    • 제26권1호
    • /
    • pp.177-213
    • /
    • 2011
  • 현재 우주활동에 의하여 발생된 손해에 대한 배상책임과 관련된 국제조약으로 1967년 우주조약과 1972년 우주손해배상책임조약이 있으며, 또한 우리나라 국내법으로 2008년 우주손해배상법이 있다. 우주조약은 우주활동에 대한 국가의 국제적 책임과 우주물체에 의한 손해에 대한 국가의 불법행위 책임에 관하여 규정하고 있다. 우주손해책임조약은 발사국의 절대적 책임, 과실책임, 연대책임, 배상청구권자, 배상청구방법, 배상청구기한, 배상청구와 국내적 구제, 손해배상액, 청구위원회 설치 등에 관하여 규정하고 있다. 우리나라 우주손해배상법은 우주손해의 정의, 우주손해책임조약과의 관계, 발사자의 무과실책임 및 책임의 집중, 발사자의 손해배상책임한도액, 발사자의 책임보험 가입, 정부의 피해자 구조 및 발사자 지원 등에 관하여 규정하고 있다. 우주사고로 인한 손해배상책임 관련 사례들로 Iridium33과 Cosmos 2251 위성충돌 사건, Cosmos 954 위성추락 사건, Martin Marietta의 위성발사 실패 사건, Westar VI 위성 작동불량 사고 등이 있으며, 이러한 우주사건에 관한 분쟁 또는 소송에 있어서 위성의 발사국, 발사자 및 제조자의 손해배상책임 부담문제에 관련하여 절대책임(엄격책임)원칙 또는 과실책임원칙이 적용되어 해결되고 있다. 우주손해책임조약의 개선방안으로 손해배상청구권자의 명확한 규정, 청구위원회의 결정의 구속력 확보 등을 들 수 있고, 우리나라 우주손해배상법의 개선방안으로 손해배상범위에 간접손해 포함, 손해배상책임 한도액의 통화단위 변경, 공동발사자의 연대책임 및 구상권 신설, 우주손해배상심의위원회의 설치 등을 들 수 있다. 우리나라는 2009년 6월 전남 고흥군 외나로도에 우주센터가 준공되어 동년 8월 및 2010년 6월 우리나라 최초 소형 우주발사체 나로호(KSLV-1)를 두차례 발사하였다. 향후 우리나라는 우주활동 과정에서 우주관련 국제조약 및 국내법상의 국제적 책임 및 우주손해에 대한 배상책임 등 문제들이 발생할 가능성이 있으므로 우리정부 및 우주물체 발사기관은 이러한 문제들에 대한 법적 제도적 대응책을 마련해야 할 것이다.

  • PDF

계약공사기간 연장에 의한 클레임 처리방안 (A Study on the Delay Claim in Construction Projects)

  • 노병옥;이상범;이호일
    • 한국건축시공학회:학술대회논문집
    • /
    • 한국건축시공학회 2001년도 학술논문발표회
    • /
    • pp.93-98
    • /
    • 2001
  • If the construction delays are occurred during the project execution, the contractual parties should inquire the delay causes and the contractual obligation. Due to the compensation of damages, the interested parties and the contractual parties are placed on the adverse situation. For reasonable of the claim and dispute, the contractual parties are needed the objective and systematic procedure method to analyze the delay. The purpose of this study is to propose a formal process model considering the case of construction delay-claims.

  • PDF

제주도 해안경관보전을 위한 토지이용규제와 보상방안에 관한 연구 (A Study on the Land Use Control and Compensation Plan for Jeju Island Coastal Landscape Conservation)

  • 이진희
    • 농촌계획
    • /
    • 제12권3호
    • /
    • pp.29-37
    • /
    • 2006
  • Jeju coastal landscape has been changed from 1980's. Construction of coastal road, rearing fm, restaurant and condominium are main reasons of destroying the Jeju coastal area. Recently, the law for preserving coastal landscape is effective to prevent diverse construction activities, the land is comparatively restricted in the coastal landscape preservation districts. The resident's attitude toward restricted landlord has been carried out in Jeju province and compensation program has been developed for landlord in the coastal landscape preservation district. To speak compensation programs, First, land compensation as if cash compensation and right of purchase claim, Second, incentive as if tax reducement or regional support, Third, assignment of development right.