• 제목/요약/키워드: insurance system

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

  • 정홍주;남상욱;박흥찬;이재석
    • 무역상무연구
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    • 제17권
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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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Dilemmas Within the Korean Health Insurance System

  • Park, Donghwi;Chang, Min Cheol
    • Journal of Preventive Medicine and Public Health
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    • 제53권4호
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    • pp.285-288
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    • 2020
  • The health insurance system in Korea is well-established and provides benefits for the entire national population. In Korea, when patients are treated at a hospital, the hospital receives a partial payment for the treatment from the patient, and the remaining amount is provided by the health insurance service. The Health Insurance Review and Assessment Service (HIRA) assesses whether the treatment was appropriate. If HIRA deems the treatment appropriate, the doctor can receive payment from the health insurance service. However, this system has several drawbacks. In this study, we aimed to provide examples of the problems that can occur in relation to HIRA assessments in Korea through actual clinical cases.

의료보험과 보건교육 (Medical Insurance and Health Education)

  • 이규식;홍상진
    • 보건교육건강증진학회지
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    • 제10권2호
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    • pp.11-21
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    • 1993
  • Recently the structure of disease is changing its form into chronic disease. Taking into consideration this, the health care system doesn't cope with this tendency. With the health care system for acute disease, it is difficult to decrease medical care cost. At this point, Health education like primary health care can reduce risk factors and possibilities of occurrence of disease. This can cut off the medical insurance finance further more cuts off the rates of insurance cost. This is why health education is the principle part of medical insurance service. Though the law shows health education must be executed in the field of Medical insurance, still it is not enough. In order to carry out health education in the medical insurance organization, the efforts we should make are as follows: 1. Recognize the importance of health education. 2. Set the clear goals in health education. 3. Organize health education system. 4. Train health workers. 5. Systematize health education service. 6. Reform the medical insurance system. 7. Evaluate the effect of health education and practice the model.

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무역금융EDI의 동향과 해상적하보험계약에의 적용과제 (The current situations of trade financial EDI and implications in application of marine insurance contracts)

  • 한상현
    • 정보학연구
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    • 제7권1호
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    • pp.121-136
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    • 2004
  • 본 연구에서는 완전한 무역전자화(paperless)를 목표로 무역업무철자에서 현재 진행되고 있는 무역금융EDI현상을 국제적 동향과 일본의 동향(주로 서류의 전자화)을 중심으로 고찰한 후, 해상적하보험분야에서 종래EDI의 활용과 시스템환경변화에 따른 새로운 EDI적용환경의 적용현상을 토대로 보험회사의 시각을 중심으로 수출입화물에 필요한 화물해상보험계약에서의 EDI적용과 향후과제들을 제시하였다.

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표준하체보험(標準下體保險)과 의학적(醫學的) 선택(選擇) (Substandard Life Insurance and Medical Selection)

  • 평미정치
    • 보험의학회지
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    • 제2권1호
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    • pp.3-16
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    • 1985
  • Necessity of life insurance is stronger for people who feel some anxiety of their health. However, in fact, it is not permitted for them to get a contract, because life insurance stands on the mutual benefit system. Life insurance must be impartial to all applicants. However, it is very reasonable that an applicant, who has high medical impairment like heart infarction or cancer, is rejected, to have a contract by underwriting decision. On the other hand, if his medical impairment is not so severe, we might accept his application by giving some restriction. Numericalratingsystem by hunter-rogers gave us one of solutions to this problem. We can keep impartiality by using more restrictive decision, in order that we demand additional payment to the impairment applicant according to his mortality. We call this system as substandard life insurance. In this system we need detail information about impairments of applicants in order to decide the condition of substandard risks. Therefore, medical examiners are required to have high diagnostic technique.

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시민안전보험 운영관리체계의 개선방안 연구 (A Legal Study on Improvement Plans for Citizen Safety Insurance Operation and Management System)

  • 이정임
    • 대한안전경영과학회지
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    • 제24권2호
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    • pp.77-85
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    • 2022
  • This study tried to suggest a systematic improvement plan to prepare a civil safety insurance operation and management system by reviewing the operation and management status of civil safety insurance, which is operated and managed by each local government autonomously. In this study, the problems of the current civil safety insurance were analyzed by dividing them into the lack of systematic management of insurance items, overlapping coverage between insurance items, and deviations in compensation limits. As a systematic improvement plan, it was suggested to secure the systemic management of guarantee items, standardize compensation standards, prepare an integrated operation and management system, and provide financial support for local governments with poor financial independence. Since the problems and improvement plans for the civil safety insurance analyzed as described above are formed by exchanging and receiving a complex mutual influence, the institutional improvement plan for the operation and management system of the civil safety insurance is not only a specific part of the study, but also comprehensively current citizens. Based on the results derived from the analysis of safety insurance, it is concluded that alternatives must be found.

개인정보 손해배상책임 보장제도의 쟁점과 과제 (Issues and Tasks of Personal Information Protection Liability Insurance)

  • 이수연;권헌영
    • 한국IT서비스학회지
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    • 제19권1호
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    • pp.37-53
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    • 2020
  • Today, our society is exposed to cyber threats, such as the leakage of personal information, as various systems are connected and operated organically with the development of information and communication technology. With the impact of these cyber risks, we are experiencing damage from the virtual world to the physical world. As the number of cases of damage caused by cyber attacks has continued to rise, social voices have risen that the government needs to manage cyber risks. Thus, information and telecommunication service providers are now mandatory to have insurance against personal information protection due to amendment of "the Act on Promotion of Information and Communication Network Utilization and Information Protection". However, the insurance management system has not been properly prepared, with information and communication service providers selecting the service operators based on sales volume rather than selecting them based on the type and amount of personal information they store and manage. In order for the personal information protection liability insurance system to be used more effectively in line with the legislative purpose, effective countermeasures such as cooperation with the government and related organizations and provision of benefits for insured companies should be prepared. Thus, the author of this study discuss the current status of personal information protection liability insurance system and the issues raised in the operation of the system. Based on the results of this analysis, the authors propsoe tasks and plans to establish an effective personal information protection liability insurance system.

산업보건서비스체계의 효율적 관리방안에 관한 연구 (A Study on Reforming the Occupational Health Care System is Korea)

  • 문옥륜;한동운;최병순;최재욱;하은희;이기효;장동민
    • 보건행정학회지
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    • 제4권1호
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    • pp.138-175
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    • 1994
  • The objectives of this study are (i) to review current situations and problems of the occupational health care system with emphasis on reforming the organizations and services, (ii) to find out a disirable occupational health system model based on integration of the occupational health system and the general health system, and finally, (iii) to suggest policy implications in occupational health services in the light of objectives of the newly emerging national health insurance reform in Korea. The major policy implications of this study are as follows: 1. In the long-run, within the occupational health system, preventive occupational health services such as employees' physical check-up, working environment examination, etc should financially be integrated with industrial accident compensation insurance. Currently separately paying expenses for each different category of services by the owner of an enterprise should be disbursed once through the payment of contributions of industrial accident compensation insurance. And then, it is necessary to strengthen and expand the role and function of industrial accident compensation insurance to cover preventive occupational health services. 2. The occupational health system should be integrated with general health system for its effective management. For the short-term policy, it is necessary to eliminate fiscal and access barrier between industrial accident compensation insurance and national health insurance by means of ex post facto settlement of accounts. The duplication of employees' physical check- ups between under the health insurance program and under the industrial health services must be coordinated in a manner either through mutual authorization by the two parties concerned or through merge into the health insurance. 3. The intent of current employees' physical check-up system focused on detection of occupational diseases, should be converted to an idea of medical surveillance system or biological moritoring system. The introduction of medical surveillance or biological monitoring system is a necessary condition to build a positive, effective and inexpensive occupational health care system.

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건강보험 40년 성과와 과제 (Achievements and Challenges of 40th Anniversary Health Insurance)

  • 이규식
    • 보건행정학회지
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    • 제27권2호
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    • pp.103-113
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    • 2017
  • There have been many achievements for 40 years since the introduction of compulsory health insurance. Despite many achievements, it has many challenges in health insurance. Aging, non-communicable disease, and low growth economy are threatening the sustainability of health insurance, and it is time to reform the health insurance. A long-term reform plan will be an absolute necessity for reform of health insurance and health care system. Health insurance and health care reform should be an extremely revolutionary content that completely changes the framework. This reform should deal with the philosophy of health, approach of medical education and doctor training, changing supply of medical service, the innovation of primary medical care, reform of public health system, the management of medical utilization, the integration of medical cure and care services, enhancing the benefit coverage, prohibition of covered and non-covered services, etc. Therefore, it is urgent to form a consensus on the necessity of reform, to establish the health insurance plan on this consensus, and to make efforts to make health insurance sustainable.

A Study on the Long-term Senior Recuperation Insurance System which Recognizes the Elderly

  • Lee, Kyung-Soo;Jung, Yun-Kyung
    • 한국임상보건과학회지
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    • 제3권4호
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    • pp.444-455
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    • 2015
  • Purpose. This study was to suggest an appropriate understanding and attitude toward the long-term senior recuperation insurance through examining the perception of the aforementioned system from the viewpoint of the elderly population. Methods. This study was conducted on 150 participants who were aged 65 years and over in a nursing hospital, a senior citizen center and participating social welfare programs in Gyeong Gi area. Researchers visited a nursing hospital, a senior citizen center, and a senior welfare center to organize times before conducting questionnaires after interviewing individual elderly participants. Results. The results are as follows: The probability of the long-term senior recuperation insurance implementation is higher amongst the younger participants, those with average health status and where the system is recognized by neighbors, relatives and/or family. The largest group of participants show only a moderate interest in the long-term senior recuperation insurance. The attitude toward using the long-term senior recuperation insurance system in the future is undetermined due to lack of awareness. Conclusions. Although the long-term senior recuperation insurance system is for all citizens, it is important to provide the correct information to the target audience, the elderly, and raise the awareness of the system so that they have access to the necessary services.