• Title/Summary/Keyword: private insurance

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Dentists' Opinions in The Dental Field of Present Health Insurance Claim and Review (건강보험중 구강요양급여의 청구 및 심사에 관한 치과의사의 견해)

  • Chang, Yong-Seog;Ahn, Yong-Woo;Park, June-Sang;Ko, Myung-Yun
    • Journal of Oral Medicine and Pain
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    • v.30 no.2
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    • pp.215-230
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    • 2005
  • The study was intended to investigate how dentists in private dental clinic thought on the present claim and review of dental insurance to reflect it in future establishing dental insurance policies. 1,465 dentists who were running own dental clinic in Pusan Metropolitan City and the south part of Kyungsang province were surveyed in February, 2004. A total of 406 copies of finished questionnaire were finally retrieved and analyzed. The findings are as follows. 1. About insurance claim affairs : Most of the subject of insurance claim was by dentist himself or dental hygienist(nurse). Agency claiming was carried under 20% of total insurance claim. 2. The degree of attendance on insurance lecture : The degree of attendance on insurance lecture was relatively low. 3. Filing a protest against insurance claim : Filing a protest against insurance claim was reavealed about half-and-half for "have been" or "have not been". 4. Private clinic dentist,s opinion about the regulations affecting review of dental insurance : Private clinic dentists opinion about current guide for insurance review of dental fee was“the guidance is difficult and unfair cutback of claim fee may be carried”. 5. The affairs about health insurance review agency : About 70% of private clinic dentists have dissatisfaction on health insurance review agency. 6. Standpoint of private clinic dentists about issuance of receipt for dental fee : About 70% of private clinic dentist have an difficulty in issuance of receipt for dental fee. 7. The affairs about change insurance noncoverage treatment to insurance coverage treatment : Most of private clinic dentists hoped that insurance coverage about full mouth scaling, pit and fissure sealant, fluoride application. But they do not hoped that insurance coverage about geriatric denture, prothodontic treatment except precious metal, photopolymerization resin treatment.

Cyber Insurance and Distribution Channels

  • Kwak, Young-Arm;Cho, Young-Sang
    • Journal of Distribution Science
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    • v.16 no.5
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    • pp.61-70
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    • 2018
  • Purpose - These days, an individual user, private entity, hears everyday news of hacking and personal information leakage in the era of a most-connected society. This study investigates cyber attack, cyber insurance and distribution channels for insurance goods in South Korea by analyzing various cases of cyber attacks in domestic and overseas case. Research design, data and methodology - This study adopted various study cases instead of the one large case for deep quality analysis, and focused on various cases of domestic and overseas cyber attacks with insurance. Result - As a result of analyzing the cases that were hacked, types of massive losses and damages arising out of internet blackout due to cyber risks are paralyzation of public and private website and portal, electronic administrative system, public infrastructure, and consequently a normal operation of nation is impossible. These losses and damages however can be coverable under cyber insurance. Conclusions - This paper suggests insurance carriers, as suppliers, should provide multiple channels to sell to the customer and should expand the strategy of advertisement and promotion in order for them to change their mind and compare the price and value of the information of individual users and private entity in view of cost savings.

The Determinants and Comparison of Health Behavior and Health Service by Private Medical Insurance on National Health-Nutrition Survey (국민건강영양조사 대상자들의 민간의료보험 가입 요인 및 가입여부에 따른 건강행태·의료이용 비교)

  • Lee, Yong-Chul;Im, Bock-Hee;Park, Young-Hee
    • The Journal of the Korea Contents Association
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    • v.10 no.12
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    • pp.190-204
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    • 2010
  • This study firstly examined the socioeconomic and health factors associated with infiltration of private health insurance. Secondly, we compared health behavior, outpatient and inpatient use of private health insured with uninsured. The method of this study is that secondary analysis of the 2008 Korea National Health and Nutrition Survey was conducted for 7178 respondents aged 19 over. We use the logistic regression and t-test for data analysis. The first dependent variable was dichotomy which is divided to private health insured or uninsured and the second dependent variable was the presence and frequency of outpatient and inpatient use. The descriptive variables was gender, age, marital status, income, education, occupation, type of national health insurance, residential area, self confidence of health, prevalence rate of common disease, activity limitation, drinking and smoking status. The result of the major findings are as follows. First, 59 under aged person, married person, people in the higher brackets of income, national employee insured were more likely to infiltrate private health insurance. The poor self confidence of health, activity limitation, person with hypertension or allergic rhinitis and smoker were negatively related in infiltrating private health insurance. Second, private health insured did more preventive behavior such as self-paid health examination, cancer screening, regular exercise than uninsured. Third, private health insured was positively related with the presence of outpatient use and frequency of inpatient use

A Study on the Application of Blockchain to Accounts Receivable Insurance to Small and Mid-Size Businesses (중소기업 매출채권보험 활성화를 위한 블록체인 적용방안 연구)

  • Kwon, HyukJun;Kim, Hyeob
    • The Journal of Society for e-Business Studies
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    • v.24 no.4
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    • pp.135-149
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    • 2019
  • Accounts receivable insurance is a system in which small and medium-sized enterprises insure the accounts receivables acquired by the purchasing company, and the insurance company pays when the purchaser fails to pay the debts. Accounts receivable insurance is a very effective means of eliminating the risk of loss due to the counterparty default, and it is economically effective to protect the domestic industry by preventing the bankruptcy of one company leading to a chain bankruptcy of other companies. In this study, we constructed a business model of the accounts receivable insurance, by building an infrastructure based on a private blockchain in activating the accounts receivable insurance accounts. The accounts receivable insurance platform using these blockchain technologies not only addressed the problem of document and reliability verification for insurance, but also sought ways to facilitate accounts receivable insurance by small businesses through rapid transaction rates, easy network expansion and access management based on private blockchain.

The Job Stress and Mental Health of the Insurance Reviewer (보험심사 근무직의 직무스트레스와 정신건강)

  • Kyoungjin Song;Jeongwon Lee
    • Journal of Service Research and Studies
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    • v.11 no.1
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    • pp.31-44
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    • 2021
  • The net function of the domestic medical insurance system is highly regarded, but due to the problem of incomplete coverage, the public wants to secure coverage through private medical insurance subscription. As a result, the subscription rate of private medical insurance has recently increased, and the billing rate has also increased. As the number of people seeking private medical insurance increased, workers at private medical insurance companies are experiencing increased job stress and side effects, especially for insurance reviewers who are in charge of paying insurance, such as communicating with customers who claimed insurance and contributing to the company's profit. In response, this study analyzed the effects of job stress on mental health of insurance reviewers and conducted a descriptive survey study to reduce job stress of insurance reviewers and promote mental health. The analysis shows that job stress for insurance reviewers has a significant impact on mental health (+). In detail, job stress has a significant impact on all four factors: social performance and self-confidence, depression, sleeping disturbance and anxiety, and general well-being and vitality. This study showed that job stress in insurance reviewers has a significant (+) impact on mental health. Job stress can cause side effects in organizational aspects, such as reducing enthusiasm for job performance and increasing turnover and resignation rates, but it can also worsen individual physical health and cause diseases such as depression and anxiety, causing mental health to be impoverished. Therefore, in order to prevent this, appropriate work stress prevention methods and countermeasures should be provided to help reduce work stress and improve mental health.

Determinants of Purchasing Indemnity Private Health Insurance among Adolescents and Children (소아 및 청소년의 실손형 민간의료보험 가입 결정요인)

  • You, Chang Hoon;Kang, Sungwook;Choi, Ji Heon;Kwon, Young Dae
    • The Journal of the Korea Contents Association
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    • v.18 no.10
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    • pp.99-110
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    • 2018
  • As interest in adolescent and children's health risks increases, there is an increase in subscriptions to indemnity private health insurance. The purpose of this study was to investigate determinants of purchasing indemnity private health insurance. We conducted panel logit regression analysis on the sample of 4,567 adolescent and children using Korean Health Panel data from 2009 to 2015. As a result, it was analyzed that the participation of private health insurance for children and adolescents was affected not only by the characteristics of children and adolescents (age, birth order, residence, disability) but also by the characteristics of father (indemnity, disability, chronic disease) and mother (age difference between her and her children, indemnity, unmet needs) and the economic level of households (income). In views of this study, it is necessary to continuously implement policies to strengthen the healthcare of children and adolescents in order to alleviate the anxiety about the health risks of children and the burden of medical expenses caused by late marriages and maternal births. In particular, it is necessary to consider policies for multi-child families and vulnerable classes.

The Influence of Private Health Insurance on Admission among Some Patients with Cervical or Lumbar Sprain (민영의료보험 가입이 일부 경·요추부 염좌 환자의 입원에 미치는 영향)

  • Jang, Dong-Ryul;Kang, Myung-Geun
    • Journal of agricultural medicine and community health
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    • v.37 no.2
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    • pp.84-95
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    • 2012
  • Background: In Korea, private health insurance has neglected to induce externality on national health insurance by moral hazard. Therefore, we conducted this study in order to explore the influence of private health insurance on unnecessary medical utilization among patients with cervical or lumbar sprain. Method: The study examined a population of 449 patients (admission, 384; out-patient; 85) diagnosed with simple cervical or lumbar sprain without neurological symptoms at 20 small hospitals or clinics in Gwangju and Jeollanam provinces from Jul. 1 to Aug. 31 2008. The data were collected using structured, self-administrated questionnaire which collected information such as whether or not the patient was admitted (as a dependent variable), whether or not they had private health insurance (as a independent variable), and covariates such as socio-demographic characteristics, the factors related to the sprain, and characteristics of the insurance provider. Results: From hierarchical multiple logistic regression analysis, it was found that the admission rate of patient with private health insurance was higher than that those without it (Odds ratio=3.31, 95% Confidence interval; 1.14-9.58), meaning that private health insurance was an independent factor influencing the admission of patients with these conditions. Other determinants of admission were patient age and physician referral. Conclusions: This study is the first empirical study to explore the influence of private health insurance on inducing moral hazard in admission services, specifically among patients with cervical or lumbar sprain. Regulation of benefits provided by private health insurance may be necessary, as the effect of this moral hazard may mean existence of externality.

Enrollment in Private Medical Insurance and Utilization of Medical Services Among Children and Adolescents: Data From the 2009-2012 Korea Health Panel Surveys

  • Ryu, Dong Hee;Kam, Sin;Doo, Young-Taek
    • Journal of Preventive Medicine and Public Health
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    • v.49 no.2
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    • pp.118-128
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    • 2016
  • Objectives: The purposes of this study were to examine the status of children and adolescents with regard to enrollment in private medical insurance (PMI) and to investigate its influence on their utilization of medical services. Methods: The present study assessed 2973 subjects younger than 19 years of age who participated in five consecutive Korea Health Panel surveys from 2009 to 2012. Results: At the initial assessment, less than 20% of the study population had not enrolled in any PMI program, but this proportion decreased over time. Additionally, the number of subjects with more than two policies increased, the proportions of holders of indemnity-type only ('I'-only) and of fixed amount+indemnity-type ('F+I') increased, whereas the proportion of holders with fixed amount-type only ('F'-only) decreased. Compared with subjects without private insurance, PMI policyholders were more likely to use outpatient and emergency services, and the number of policies was proportionately related to inpatient service utilization. Regarding outpatient care, subjects with 'F'-only PMI used these services more often than did uninsured subjects (odds ratio [OR], 1.69), whereas subjects with 'I'-only PMI or 'F+I' PMI utilized a broad range of inpatient, outpatient, and emergency services relative to uninsured subjects (ORs for 'I'-only: 1.39, 1.63, and 1.38, respectively; ORs for 'F+I': 1.67, 2.09, and 1.37, respectively). Conclusions: The findings suggest public policy approaches to standardizing PMI contracts, reform in calculation of premiums in PMI, re-examination regarding indemnity insurance products, and mutual control mechanisms to mediate between national health insurance services and private insurers are required.

The Private Health Insurance Market in the UK over the Period 1986 -1995 : an Analysis of Main Developments

  • Hong, Seon-U
    • Research in Community and Public Health Nursing
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    • v.8 no.2
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    • pp.403-415
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    • 1997
  • 이 논문은 지난 10년간(1986-1995)의 영국의 사건강보험(private health insurance) 시장의 전반적 추이를 관찰, 국민 의료 써비스(National Health Service)와의 관계 및 역할 변화를 고찰한 것이다. 가장 대표적인 PMI(private medical Insurance)와 PHI(permanent health Insurance), LTCI(long term care insurance)를 집중 연구하였으나 지면관계상 PMI를 중점적으로 다루고 PHI나 LTCI는 간략히 소개하였으며 관련도표는 모두 생략하였다. 영국의 사건강보험 시장은 1990년대 초의 정체기를 거친후 이제 서서히 가시적인 성장을 보이고 있다. 많은 영국 국민들은 정부가 기본적인 복지혜택 외에는 더 이상의 치료와 미래 간호를 보장할 수 없다는 사실을 이해하고 있으나 아직 대부분은 어떤 형태로든 NHS 외의 보호장치를 가지고 있지 못하다. 따라서 영국민의 사건강보험에 대한 관심은 점차 고조되고 있는 것이 현실이다. 사건강보험 시장의 성장은 몇가지 중요한 요소에 좌우된다 첫째, NHS의 capacity이다. 달리 말하면, NHS에 대한 정부의 각종 정책과 태도는 시장에 직접적인 영향을 미친다. 둘째, 경제성장은 상당히 결정적인 요소이다. 1990년대 초의 침체에서 이미 보았듯이 경기후퇴와 그와 동반된 높은 실업은 사적 의료써비스의 구매력을 감소시킨다. 셋째, 시장을 극대하려는 보험회사의 노력 또한 배놓을 수 없는 중요한 요소이다. 새로운 구매자를 위해서 또 시장에서의 치열한 경쟁에서 살아 남기 위해서 보험회사들은 폭넓은 범위의 상품을 개발하고 노동자들을 위한 값이 저렴한 상품들을 소개시켜 왔다. 비록 이런 종류의 저렴한 상품들은 커버하는 범위가 불충분하지만 총 인구의 보험 가입을 증가시킨다. 현 상황에서 PMI는 NHS에 대한 대안이 되지 못하고 단지 부분적 대용책일 뿐이다. 또한 시장을 극대시키려는 정부의 노력에도 불구하고 극소수의 사람들만이 PHI에 커버되고 있다. LTCI는 너무 비싸 지극히 부자들만이 구매할 수 있을 뿐, 평균임금 또는 그 이하의 사람들은 보험료를 감당할 수 없다. 한편. 영국의 사건강보험 시장에 대한 전망 또한 복합적이다. 즉 PMI 부문은 서서히 성장, PHI 부문은 계속적으로 꾸준히 증가, LTCI 부문은 제한적이기는 하나 발전하리라 보는 것이다. 따라서 미래시장을 예견하는 것은 그리 쉽지 아니하다. 결론적으로 영국국민은 질병, 또는 치료가 필요한 경우 전적으로 NHS에 의존하고 있으며 현재의 사건강보험은 다양한 질병위험에 대한 보호를 제공하기보다는 단순히 부가적인 혜택에 지나지 않을 뿐이다.

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Factors of Welfare Recognition toward Health Insurance and Health Care: Using 2013 Korea Welfare Panel Study (건강보험 및 보건의료에 대한 복지인식에 영향을 주는 요인: 2013년 한국복지패널 자료를 이용하여)

  • Park, Young-Hee
    • The Korean Journal of Health Service Management
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    • v.9 no.3
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    • pp.115-126
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    • 2015
  • Objectives : This research was performed to investigate the characteristics and determination factors of health care policy satisfaction and welfare recognition for health insurance & health care financing. Methods : The utilized data were 4,174 cases who responded to a welfare recognition survey in the 8th wave of the Korea Welfare Panel Study (2013). The statistical methodology used in this study is the multiple regression model. Results : The significant affecting factors of health care policy satisfaction were age, education, household income, welfare attitudes, and health status. Medical utilization & private medical insurance were not related to health care policy satisfaction. The affecting factors of health insurance reinforcement were age, health status, welfare attitudes. The affecting factors of health care financing expansion were age, economic activity type, medical utilization, welfare attitudes. The affecting factors of welfare attitudes were age, economic activity type, household income, health insurance, and health status. Conclusions : Health care policy satisfaction, health insurance reinforcement, and health care financing expansion were all affected by age and welfare attitude; but this was not the case for private health insurance. This study recommended that the Korean government provide active planning for reinforcement of health insurance and publicity of the health care system in order to accord with the prospects of people.