• The Korean Journal of Applied Statistics
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• v.25 no.1
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• pp.101-114
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• 2012

In car insurance, the loss ratio is the ratio of total losses paid out in claims divided by the total earned premiums. In order to minimize the loss to the insurance company, estimating extreme quantiles of loss ratio distribution is necessary because the loss ratio has essential prot and loss information. Like other types of insurance related datasets, the distribution of the loss ratio has heavy-tailed distribution. The Peaks over Threshold(POT) and the Hill estimator are commonly used to estimate extreme quantiles for heavy-tailed distribution. This article compares and analyzes the performances of various kinds of parameter estimating methods by using a simulation and the real loss ratio of car insurance data. In addition, we estimate extreme quantiles using the Hill estimator. As a result, the simulation and the loss ratio data applications demonstrate that the POT method estimates quantiles more accurately than the Hill estimation method in most cases. Moreover, MLE, Zhang, NLS-2 methods show the best performances among the methods of the GPD parameters estimation.

• 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.

• The Journal of the Korean life insurance medical association
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• v.9
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• pp.116-121
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• 1990

• The Journal of the Korean life insurance medical association
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• v.2 no.1
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• pp.152-181
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• 1985

A statistical analysis on the cardiothoracic ratio in insurance medicine was carried out for 5,200 insured persons who were medically examined including photofluorography of the chest at the Honam medical department, Dong Bang life insurance Company, Ltd from November, 1979 to August, 1984. The results were as follows: 1. The mean value of the cardiothoracic ratio in all of the insured was $44.2{\pm}4.3%$. The mean value of the cardiothoracic ratio was $43.1{\pm}4.1%$ in all males and $45.2{\pm}4.2%$ in all females, and the difference of the values between males and females showed statistical significance(P<0.001). In each age group, the mean value of the cardiothoracic ratios of female was higher than that of male without exception and the difference of the values between males and females showed statistical significance(P<0.001). The mean value of the cardiothoracic ratio showed gradual increase with age from the second to sixth decade in male(P<0.05 or 0.001 after fourth decade) and from the second to seventh decade in female(P<0.05 or 0.001 from the second to sixth decade). 2. Correlation between both sexes and among age groups relating to the cardiothoracic ratios of the insureds seen to be a physiological phenomenon of the cardiac size and should be considered on the rating of the cardiothoracic ratio. Based on the correlation above mentioned and an author's assumption that the incidence of normal and abnormal cardiothoracic ratios in each age group would show the same rate in male and female, author prepared a modified rating table from the existing table; in male group the existing rating table is used and in female group the ratings of 0, 30-50, 50-100 and 100-D are to calculate by the cardiothoracic ratio of 51%or under, 52-56%, 57-61% and 62% or over respectively in the age group below 39, by the cardiothoracic ratio of 52% or under, 53-57%, 58%-62% and 63% or over respectively in the age group of 40-49, by the cardiothoracic ratio of 53% or under, 54-58%, 59-63% and 64% or over respectively in the age group over 60. 3. The relative frequency distribution polygons of the cardiothoracic ratio of both sexes drawn in a pair on one coordinate plane revealed lying in juxtaposition each other horizontally and showed the shifting of females polygon to male's one toward the direction of greater value of the cardiothoracic ratio at a short distance which increased gradually with age. 4. The minimum cardiothoracic ratio was 31.2% and the maximum cardiothoracic ratio was 63.6% in all of the insured. 5. In each age group, no significant sex difference was found in the relative frequency distribution of ratings by the cardiothoracic ratios of 5,200 insureds by using the rating table modified by author, while significant sex difference was found by using the existing rating table.

• Journal of the Korean Society of Safety
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• v.34 no.1
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• pp.115-121
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• 2019

Background: Due to the diversification and advancement of research, researchers have become to deal with a variety of chemical and biological harmful materials in the laboratories of universities and research institutes and the risk has increased as well. Therefore, it is necessary to strengthen the social safety net for laboratory accidents by strengthening the compensation to the level comparable to that of Korean Workers' Compensation & Welfare Service, when the researchers become physically disabled by laboratory accidents. The purpose of this study is to secure researchers' health rights and to create a research environment where researchers can work with confidence by strengthening the compensation to the level comparable to that of Korean Workers' Compensation & Welfare Service. Method: We analyzed the laboratory accidents by year, injury type, severity of accident and disability grade with the 6 year data from 2011 to 2016, provided by Laboratory Safety Insurance. Based on the analysis result, we predicted the financial impact on Laboratory Safety Insurance if we introduce a compensation annuity by disability grade which is similar to Injury-Disease Compensation Annuity of Korean Workers' Compensation & Welfare Service. Result :As of 2011, the insured number of Laboratory Safety Insurance was approximately 700,000. The Average premium per insured was KRW 3,339 and there were 158 claims. Total claim amount was KRW 130 million, whereas the premium was about KRW 2.3 billion. The loss ratio was very low at 5.75%. If we introduce a compensation annuity by disability grade similar to Injury-Disease Compensation Annuity of Korean Workers' Compensation & Welfare Service, the expected benefit amount for 1 case of disability grade 1 would be KRW 1.6 billion, assuming 2% of interest rate. Given current premium, the loss ratio, the ratio of premium income to claim payment, is expected 41.4% in 2017 and 151.6% in 2026. The increased loss ratio due to the introduce of the compensation annuity by disability grade is estimated to be 11.0% in 2017 and 40.4% in 2026. Conclusion: Currently, laboratories can purchase insurance companies' laboratory safety insurance that meets the standards prescribed by Act on the Establishment of Safe Laboratory Environment. However, if a compensation annuity is introduced, it would be difficult for insurance companies to operate the laboratory safety insurance due to financial losses from a large-scale accident. Therefore, it is desirable that one or designated entities operate laboratory safety insurance. We think that it is more desirable for laboratory safety insurance to be operated by a public entity rather than private entities.

• The Journal of the Korean life insurance medical association
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• v.7 no.1
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• pp.180-188
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• 1988

A study on the standard cardiothoracic ratio calculated from the photofluorography film of chest in a total of 8,030 insured persons(3,449 men and 4,581 women) was undertaken. The results were as follows: 1) The linear regression equations were formed from the 99% confidence ilmits of actually measured average cardiothoracic ratio by weight index. The cardiothoracic ratios by weight index estimated by above mentioned equations, namely theoretic values of cardiothoracic ratio, should be regarded as the standard cardiothoracic ratios. 2) It seems that the standard cardiothoracic ratio${\pm}10%$ deviation should be regarded as the normal limits of cardiothoracic ratio. 3) The tables of standard cardiothoracic ratio by weight index and the normal limits of cardiothoracic ratio by weight index were presented. 4) The average weight index and cardiothoracic ratio in all males and females were 0.993 and 43.3%, and 0.997 and 46.3% respectively. 5) In order to evaluate the cardiothoracic ratio more accurately, the establishment of the standard cardiothoracic ratio by build is considered to be reasonable.

• Journal of the Korean Institute of Navigation
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• v.18 no.4
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• pp.59-81
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• 1994

Korean property and liability insurance companies have underwrited hull insurance without proper undrewriting ability. But after April 1996. in case of Korean insurance market being opened the companies have to make hull insurance rate by themselves. Accordingly, in this study, the writer embodies important factors in making hull insurance rate by an empirical survey. In empirical survey, the writer used a questionnaire, 74 proper data was obtained from 96 officers working in making hull insurance rate in 12 Korean property and liablity insurance companies and 24 the foreign companies at home. Reliability was tested by Cronbach's Alpha and a conceptual validity by Factor Analysis. Hypothesis estabilished in this study was tested by Correlation and Multiple Regression Analysis. Results of testing hypothesis are as follows: Firstly, the traits of insurer and the assured influence significantly(P<0.05) on making hull insurance rate. Secondly, expected loss ratio, ship manager, ship's age, insured amount, level of the cost of repairing and salvage, shipowner, period of insurance, level of overseas rating, profit and expense, trading limits, ship's classification, conditions of insurance, and ship's size influence significantly(P<0.05) on making hull insurance rate.

• The Journal of the Korean life insurance medical association
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• v.28 no.1_2
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• pp.15-18
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• 2009

Background: Recent emergence of drug-resistant tuberculosis such as multidrug-resistant tuberculosis(MDR-TB) or extensively drug-resistant tuberculosis(XDR-TB) has become important health care problems. It has also became grave issues for insurance industries in determining medical risks. We have therefore strived to analyze the comparative mortality rates for drug-resistant tuberculosis through utilization of results from previous articles. Methods: Comparative mortality was calculated from source articles using mortality analysis methods. Results: Mortality ratio of MDR-TB was estimate to 1200%, and excess death rate was 110 per 1,000. Comparative mortality between MDR-TB and XDR-TB by Korean $study^{(1)}$ were 1750, 382, 405, 443, 1025, and 357%, for each 10 months study intervals, respectively. Total mortality ratio was 594% and total excess death rate was 60 per 1,000person. It was determined that the risk of XDR-TB was much greater than MDR-TB. Discussion; Pending the development of a novel anti-tuberculosis drug, it would be prudent to steer clear insuring XDR-TB during underwriting phase due to high medical cost that it creates.

• Health Policy and Management
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• v.27 no.1
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• pp.30-38
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• 2017

Background: This study aims to analyze the behavioral changes of healthcare providers and influencing factors after the reviewer unification of auto insurance medical benefit claims by an independent review agency. Methods: The comparison data were collected from the second half of 2013 and the same period of 2014. The key indicators are the number of admission days, the number of outpatient visits, inpatient ratio, inpatient medical expenses, and outpatient medical expenses. Results: Four indicators (number of admission days, number of outpatient visits, inpatient ratio, and outpatient medical expenses) showed statistically significant drops, while one indicator (inpatient medical expenses) showed no significant change. Conclusion: The reviewer unification of auto insurance medical benefit claims by an independent review agency showed significant reduction in cost and patient days.

• Korea Journal of Hospital Management
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• v.26 no.1
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• pp.71-82
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• 2021

Purpose: The purpose of this study is to estimate incomes and costs of the medical clinics by using secondary data. Methodology: The medical incomes and costs were estimated from 405 clinics operated by sole practitioner providing out-patient services among all clinics subject to the Medical Cost Survey on National Health Insurance Patients in 2017, excluding dental clinics and oriental medical clinics. The incomes and costs of the medical clinics were reflected with incomes and costs of health insurance benefits and were calculated by types of medical services (i.e., basic care, surgery, general treatment, functional test, specimen test and imaging test). The costs were classified as follows: labor costs, equipment costs, material costs and overhead costs. Secondary data was used to estimate the incomes and costs of the medical clinics. For allocation bases for costs for each type of the medical service, the ratio of revenue from health insurance benefits by types of medical services was applied. However, labor costs were calculated with the activity ratio by types of medical services and occupations, using clinical expert panel data. Finding: The percentage of health insurance income for all medical income was 73.1%. The health insurance cost per clinic was 401,864 thousand won. Labor cost accounted for the largest portion of the health insurance income was 191,229 thousand won (47.6%), followed by management cost was 170,018 thousand won (42.3%), materials cost was 35,434 thousand won (8.8%), and equipment costs was 5,183 thousand won (1.3%). Practical Implications: This study suggests a method of estimating incomes and costs of medical clinic services by using secondary data. It could efficiently provide incomes and costs to assess an appropriate level of the health insurance fee to the clinics.