• Proceedings of KOSOMES biannual meeting
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• 2017.04a
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• pp.243-243
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• 2017

• THE INTERNATIONAL COMMERCE & LAW REVIEW
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• v.72
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• pp.57-80
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• 2016

Since 2006, the Law Commission and Scottish Law Commission have been engaged in a major review of insurance contract law, finally leading to the legislation of Insurance Act 2015. According to the enforcement of the Insurance Act 2015 on 12 August 2016, ss 18~20 of the Marine Insurance Act 1906(MIA 1906) were repealed and substituted by the new concept of fair presentation. This article intends to analyze the legal implications through the comparative research between the duty of fair presentation in Insurance Act 2015 and ss 18~20 of MIA 1906. The major changes in Insurance Act 2015 are designed to (1) encourage active engagement by the insurer rather than passive underwriting, asking questions of the insured if the desired information is not provided at the stage of proposal; (2) encourage policyholders to structure and signpost their presentation in an clear and accessible way, and prevent data dumps; (3) give guidance as to how the insured should prepare a fair presentation, by undertaking a reasonable search of available information and giving examples of what circumstances might be material; (4) clarify whose knowledge in the insured's organization is attributed to the insured for the purposes of disclosure; (5) clarify the exceptions to the duty of disclosure, including circumstances "which are known or presumed to be known to the insurer"; and (6) replace the remedy of avoidance in all circumstances with more proportionate remedies. This is a default regime, which may be altered by agreement between the parties.

• The Journal of the Korean dental association
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• v.48 no.6
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• pp.459-468
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• 2010

International Classification of Disease (ICD-10) is widely used as a crucial reference not only in the medical diagnosis of diseases but also within the health insurance system. It makes possible for medical personnel to make decisions systematically and for the people working in the health insurance or public health industries to better understand medical issues. However, this classification is often not enough or acceptable in a clinical setting. Many countries amend in their own way to make it more appropriate for their people. Korean Classification of Disease (KCD-5) was made by adding a 5 digit code for some diseases to clarify the conditions of the patients. The authors found problems of KCD-5 in temporomandibular disorders and several related medical problems. Medical treatment for these problems had not been covered even by public health insurance until 2000 in Korea. For the last decade, private insurance companies have introduced new items for reimbursement of the treatment fees the patients actually pay. The authors assumed that many patients with these medical problems encountered difficulties in the reimbursement from private insurance companies because KCD-5 did not classify these medical conditions appropriately. An overview of KCD-5 and suggestions for improvement are introduced in this study.

• Korea Journal of Hospital Management
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• v.21 no.4
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• pp.45-54
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• 2016

The purpose of this study is to identify patient and hospital characteristics with pulmonary tuberculosis and to analyze factors which were influencing length of stay and treatment. The Korean National Hospital Discharge In-depth Injury Survey database from 2006 to 2012 was used for analysis. Study subjects were 4,704 patients and analyzed by using frequency, chi-square and logistic regression through using STATA 12.0. To avoid selection bias, we used propensity score matching. Analysis results show that the length of stay and treatment of pulmonary tuberculosis was different between insurance types. Patients characteristic(female, comorbidity, admission by outpatient department, medical insurance type) and hospital characteristic(500-999 beds, over 1000 beds) significantly influence length of stay. Admission by outpatient department and over 1000 beds are significantly influence treatment. Based on these findings, it is necessary to clarify between length of stay and treatment outcome by medical aids beneficiaries and audit hospitals follow discharge guidelines in pulmonary tuberculosis patients.

• THE INTERNATIONAL COMMERCE & LAW REVIEW
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• v.26
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• pp.173-199
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• 2005

The MIA 1906, s.78(4) provides that it is the duty of the assured and his agents, in all cases, to take such measures as may be reasonable for the purpose of averting or minimising a loss. In many cases the statutory duty will be unimportant, since rights, duties and liabilities declared by the Act or implied into marine insurance contracts by law may be modified by agreement, and many contracts contains a sue and labour clause which effectively reproduces and/or to modifies the statutory duty. The effect of such contractual provisions will, of course, be a matter of construction, though modern sue and labour clauses tend to reflect the principles contains in section 78. However, it must not be assumed that the terms of all contractual sue and labour clauses are, or will remain, identical, either with each other or with the statutory duty. The purpose of this study is to clarify the ambit of sue and labour.

• Journal of Acupuncture Research
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• v.33 no.2
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• pp.61-76
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• 2016

Objectives : This study was designed to clarify population-social characteristics that influence the utilization patterns of hospitalized patients in a traditional korean hospital, thereby providing clinical data which would help further improvements of traditional korean medical service in particular the Acupuncture and Moxibustion. Methods : We investigated population-social characteristics and annual utilization patterns of all patients who were hospitalized for more than 24 hours in a Korean Medical Hospital from January 2005 to December 2014. The obtained data were recorded in the EMR chart and statistical analysis was performed using SPSS 21.0. Additionally, data from the patients admitted to the department of Acupuncture and Moxibustion were analyzed separately. Results : 1. All inpatients had a significant annual difference in age, gender, hospitalized department, and disease code annually but not in re-hospitalization number. Inpatients of the department of Acupuncture and Moxibustion also varied in their age, gender, and disease code annually, but not in re-hospitalization number. 2. Pearson correlation analysis on all inpatients showed that the mean days of hospital treatments had a negative correlation with all variables except medical care insurance. Total cost, cost per day per person and recuperation cost had a positive correlation with all variables except medical care insurance. There was no meaningful relationship between nonrecuperation cost and the variables. 3. Stepwise multiple regression analysis on all inpatients showed that the mean days of hospital treatments had a negative correlation with all variables except automobile insurance. The total hospitalization costs had a positive correlation with both general insurance and medical care insurance. Cost per day per person and recuperation cost had a positive correlation with the females. There was no meaningful relationship between non-recuperation cost and the variables. 4. Pearson correlation analysis on inpatients of the department of Acupuncture and Moxibustion inpatients showed that the mean days of hospital treatments had a positive correlation with all variables except general insurance and automobile insurance. Total cost and recuperation cost had a positive correlation with all variables except medical care insurance, and cost per day per person had a positive correlation with females and general insurance. There was no meaningful relationship between non-recuperation cost and the variables. 5. Stepwise multiple regression analysis on inpatients of the department of Acupuncture and Moxibustion inpatients, the mean days of hospital treatments, total cost, cost per day per person and recuperation cost had a positive correlation with general insurance. There was no meaningful relationship between non-recuperation cost and the variables. Conclusion : Population-social characteristics of inpatients annually varies, and the change influences the utilization pattern.

• 한국노년학
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• v.39 no.1
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• pp.1-20
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• 2019

Recently, the Ministry of Health and Welfare has emphasized the necessity to build community care, and the interest of health care- long-term care-social welfare system continues. In order to examine the future vision of long-term care for elderly people, which can be a core system in establishing community models for elderly people in the future, we will implement aging in place as a national policy project. It is meaningful to analyze in depth the case of Japan's policy implementation through the amendment process of long-term care insurance system. The purpose of this study is to examine the concept definition, operating system, and major promotion process of the Integrated Care System in Japan and to suggest policy implications for the future Korea long-term care insurance system. As a result of reviewing the operation status and revision process of the long-term care insurance system for establishing the Integrated care system in Japan, it is necessary to clarify the basic principles and construction of community care system, diversification of residence type and upgrading work, establishment of linkage network of health care-long term care-social welfare, expansion of support for family and self-mind.

• THE INTERNATIONAL COMMERCE & LAW REVIEW
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• v.33
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• pp.63-89
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• 2007

The UCP is an authoritative compilation of the customs and practice of letters of credit observed by most of the participants in the transaction. It remains the most successful set of private rules for trade ever developed. First issued in 1933, the UCP has been through five revisions, the latest being the present UCP 500, which came into force in 1994. Since 1994, new developments in transport, insurance, electronic commerce and banking industry have spurred the current revision of the rules. The ICC Banking Commission approved UCP 600 on October 25, 2006 by a unanimous vote of 91 to 0. The revision, which will come into effect on July 1, 2007, incorporates a number of changes from UCP 500 as follows : UCP 600 has a leaner set of rules, with 39 articles rather than 49 articles of UCP 500; New sections on "definitions" and "interpretations" have been added to clarify the meaning of ambiguous terms; The phrase "reasonable time" for acceptance or refusal of documents has been replaced by a firm period of five banking days; UCP 600 allows for the discounting of deferred payment credits. However, UCP 600 has two main problems such as the inconsistency with insurance industry and the banking community-oriented rules. We have some months before the commencement of UCP 600. From today to the commencement of UCP 600, we should study the full contents of UCP 600 and the influences on the trade industry.

• YAKHAK HOEJI
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• v.53 no.6
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• pp.368-376
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• 2009

DUR (Drug Utilization Review) originally referred to the evaluation of drug usage details: however DUR refers to the system used to support the services of prescribing and dispensing through linking from Health Insurance Review and Assessment (HIRA) Service in Korea. HIRA is going to begin the DUR enforcement for extending to nationwide coverage after pilot test. Objectives: The aims for this study were to evaluate and clarify the current opinions of the pharmacists for the recognition and acceptance rates before nationwide coverage concerning DUR system. Methods: A 16-question-questionnaire was developed and pilot tested. For 40 days of survey by both on-line and fax paper, it was carried out on 80 pharmacists working at community pharmacy in Goyang-si, Gyeonggi-do. Results: Most of answers were broadly positive and interested in begining the DUR system and kept in mind that the goal of DUR is safety guarantee for people. On the other hand, most of answerers worry that delay of patient waiting time and inharmonious communication with doctors in DUR processing can be a major obstacle to begin the DUR system. Conclusion: To solve several problems, the most important things are to make good reciprocal relationships between doctors and pharmacists, investigate intervention tool to shorten patient waiting time, and activate educational program of inspecting items for the pharmacists.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.25 no.3
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• pp.346-354
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• 2015

Objectives: This study was conducted to evaluate the changes and regional differences of mortality and morbidity particularly respiratory system diseases in the area of exposure to coal dust(Ansim area, Dong-gu, Daegu). Methods: The authors analyzed secondary data(cancer registration data, mortality data, and health insurance data) for respiratory system diseases. We calculated age standardized incidence ratio(SIR), mortality ratio(SMR), and health care utilization ratio(SHR) using those data. Results: There were no significant differences between Ansim area(or Dong-gu, Daegu) and the control area for cancer registration data and mortality data. In the results for the health insurance data, significant increased SHR in asthma was observed compared to the control area. Conclusions: Although confounders such as selection bias were not clearly ruled out, our findings reveal increased asthma SHR in the area of exposure to coal dust. Further prospective studies are required to clarify the increasing respiratory disease due to exposure to coal dust.