insurance compensation
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2021 ◽  
Vol 2 (4) ◽  
pp. 569-590
Author(s):  
Dwita Pratama

The presence of online transportation can be recognized if it fulfills the requirements of the Ministerial Regulation of Transportation Act Number 108 of 2017 concerning the Implementation of Transportation of People with Public Motorized Vehicles Not on Routes. The problem that arises is when this online transportation does not have a transportation operation permit, which then the passengers do not get legal protection for it. The method used is normative juridical where the data used are primary data and secondary data and the data collection used is library research. The data obtained were analyzed qualitatively. From the discussion it can be concluded that 1.Insurance compensation for passengers who have an accident through PT Jasa Raharja is given to an online application-based transportation company that already has a transportation operation permit based on the provisions of the Ministerial Regulation of Transportation Act Number 108 of 2017 concerning the Implementation of Public Transportation with Public Motorized Vehicles Not On Routes which is carried out based on Act Number 33 of 1964 concerning the Passenger Accident Compulsory Insurance Fund, for online application-based transportation companies that do not have a transportation operation permit, in the event of an accident the passenger does not receive insurance compensation from PT Jasa Raharja. The responsibility of online transportation service providers has complied with Article 188 of Act Number 22 of 2009 concerning Traffic to compensate for the loss of passengers or shippers due to omission in carrying out transportation and road transportation services.


2021 ◽  
Vol 9 ◽  
Author(s):  
Cheng-yao Sun ◽  
Ju-fang Shi ◽  
Wen-qi Fu ◽  
Xin Zhang ◽  
Guo-xiang Liu ◽  
...  

Background: Although numerous studies have examined catastrophic health expenditures (CHE) worldwide, most focus on the general population, not on specific vulnerable groups. We aimed to analyse the extent and the influencing factors of CHE in households with breast cancer patients in China, and explore the ability of different insurances to protect these households from CHE.Methods: A multicentre, cross-sectional interview surveys was conducted in households with breast cancer patients across seven provinces/municipalities in China. CHE were defined as out-of-pocket expenditures ≥ 40% of households' non-food expenditures. Chi-square tests and logistic regression analysis were performed to identify the determinants of CHE in household with breast cancer patients.Results: In the 639 participating households with breast cancer patients, the mean out-of-pocket (OOP) expenditure accounted for ~55.20% of the mean households' non-food expenditures. The overall incidence of CHE was 87.95 and 66.28% before and after insurance compensation, respectively. The logistic regression model revealed that education, disease course, health insurance, treatment method, and income were significant predictors of CHE.Conclusions: The results indicated that medical insurance protects some households with breast cancer patients from the impact of CHE. However, their reimbursement rates were relatively low. Therefore, breast cancer still had a significant catastrophic effect on the economy of households. Policy efforts should focus on improving insurance compensation rates and relieving the economic burden of critical illnesses such as breast cancer.


2021 ◽  
Vol 11 (1) ◽  
pp. 79-90
Author(s):  
Jadranka Nižić-Peroš

The subject of this paper is a review of legislation and case law regarding personal subrogation, recourse obligation and recourse claim of the insurer for payment of insurance compensation as well as determining the amount of payment of recourse claim in civil proceedings before the court and assignment of the claim - cession. The paper starts from the point of view that the terms and institutes of subrogation, recourse and cession are very similar and that they are often identified, so we try to clearly distinguish what exactly the term refers to. In Croatian law, the right of subrogation of the insurer is most often understood as legal personal subrogation where by paying the insurance compensation the insurer assumes the legal position of its insured and consequently enabling the insurer to claim damages against the responsible person . In addition to the above, the paper also considers the statute of limitations for insurers’ recourse rights. Furthermore, the author starts from the point of view that in court proceedings initiated for recourse payment it is necessary for the court expert to clearly determine the parameters based on which the court will be able to assess in a certain percentage the possible contribution of the injured party to the damage towards the plaintiff, namely the insurer.


2021 ◽  
Vol 16 (2) ◽  
pp. 39-46
Author(s):  
A. A. Goncharova

The author considers different ways for determining the amount of insurance compensation to be paid to the participant of shared-quity construction in case of occurrence of an insured event in the form of recognition of the developer’s insolvency (bankruptcy) or foreclosure of a collateral. The purpose of the paper is to identify approaches to the determination of this amount used by insurers at different stages of implementation of the mechanism of the developer’s civil liability insurance and to analyze these approaches’ legality. The author analyzes actual jurisprudence in cases involving insurers and participants in shared-equity construction. It is established that at the first stage in the legislation there were no rules for determining the amount of insurance compensation in this area, and insurers determined it at their discretion. At the second stage, when the minimum amount of insurance compensation was consolidated in law, insurers faced controversy caused by a mismatch between the amount originally paid by the construction participant under an equity participation agreement and the amount to be paid. The author concludes that, at the second stage, the disagreement concerning the amount of insurance compensation is caused by the insurers’ abuse of right.


Work ◽  
2021 ◽  
pp. 1-9
Author(s):  
Kwan Woo Kim

BACKGROUND: Although using forklifts in industrial sites contributes to productivity, many workers have been injured or killed owing to industrial accidents caused by forklifts. OBJECTIVE: This study analyzed the characteristics of forklift accidents by employment type and work process, thereby identifying the factors contributing to industrial accidents and providing recommendations to prevent accidents. METHODS: Data on 1,061 industrial forklift accidents occurring in 2018 collected from the national injury insurance compensation database were analyzed. In addition to analyzing the accident characteristics, this study performed a risk assessment per forklift work process. RESULTS: Many accidents were associated with older workers, those employed for <  6 months, and workplaces with ≤49 workers. The risk was the highest for accidents involving caught-in objects in the loading/unloading step and collision accidents in the forward- and backward-driving steps. CONCLUSIONS: Measures are needed to prevent industrial forklift accidents. First, forklift and worker movement routes must be strictly separated or controlled by a work supervisor. It is necessary to secure a time margin for workers to avoid collapsing cargo by using an appropriate tool/jig during loading/unloading. Second, guidance, inspection, and support are needed to promote employers’ safety and health awareness in workplaces with <  50 workers. Lastly, intensive education and training concerning health and safety is required for workers with less than six months of experience.


2021 ◽  
Vol 16 (1) ◽  
pp. 91-98
Author(s):  
A. A. Goncharova

The paper explores the contradictions in judicial practice arising in the consideration of disputes between insurers and citizens — participants of share building. The objective of the paper is to identify the essence of the emerging disagreements between the subjects and determine their nature. The analysis takes into account changes in legislation affecting the field of share building. The author relies on the data of current jurisprudence. The author considers as the most common disagreements the applicability of consumer protection legislation to the relationships between the insurer and the beneficiary — the construction participant -- and the validity of payment of insurance compensation provided that the construction participant demands to transfer dwelling premises rather than monetary compensation. In both cases, the author has determined deficiencies in law. The former lacks the necessary legal rule, allowing courts to make decisions by applying different analogies of the law in resolving identical disputes. The second deficiency of the legal rule is not fully formulated, which makes the insurer’s position uncertain when replacing the lender.


2020 ◽  
Vol 17 (5) ◽  
pp. 72-79
Author(s):  
A. V. Shevchenko

The property insurance program developed by the insured determines the main requirements to the conditions, features of the conclusion, execution and termination of the concluded property insurance contracts. When it is implemented for a number of years, when there is a periodic renewal of insurance contracts on standard conditions, the insured has the need to assess the economic effectiveness of such insurance protection, preferably using quantitative indicators. Existing methods of estimating the cost-effectiveness of property insurance programs do not sufficiently take into account the stochastic nature of the insurance process and, in particular, that the resulting losses are subject to extreme type distribution laws studied within the framework of the asymptotic theory of extreme values probabilities. Therefore, for example, it is difficult to adequately assess the economic effectiveness of the property insurance program in a rather frequent situation where the total costs of the insured for paying insurance premiums exceed the total insurance compensation. The proposed statistical method of estimating the economic effectiveness of the property insurance program is based on extreme type distribution functions determined by statistical data, characterizing the claimed losses and insurance compensation paid. The cost effectiveness assessment is carried out using the cost-effectiveness indicator of the property insurance program, which is calculated according to two parameters: the expected share of insurance payments (insurance indemnities) and the premium efficiency coefficient. The expected share of insurance payments is determined by the ratio of mathematical expectations of distribution functions, which characterize the claimed losses and insurance compensation paid. The premium efficiency ratio is the ratio of the gross premium total for the property insurance program, calculated using the function of distributing the claimed losses, and the total amount of premiums paid for the entire period of the property insurance program. Adding up the values of the expected share of insurance payments (insurance indemnities) and the premium efficiency factor taking into account their weights, the value of the economic efficiency indicator of the property insurance program is obtained. The formation of a conclusion on the economic effectiveness of the property insurance program is carried out on the basis of the value of the economic efficiency indicator of the property insurance program according to the proposed scale.


2019 ◽  
Vol 2 (2) ◽  
pp. 92
Author(s):  
Juliana Bylykbashi ◽  
Eneida Sema Dervishi

Non-pecuniary damage is one of the institutes of civil law that aims to protect and restore the rights of personality laid out in certain provisions of the Constitution of the Republic of Albania and expressly referred to in Article 8 of the European Convention on Fundamental Human Rights and Freedoms. Judicial jurisprudence has rendered non-pecuniary damage in the case of health damage, physical or psychological integrity in three separate types of damage: biological damage, moral and existential damage. The subject of this paper will be one of the figures of non-pecuniary damage, biological damage or otherwise called damage to health, being a matter of little or no treatment and the problems it faces in Albanian jurisprudence. One of the topics to be dealt with in this paper is the manner and criteria for calculating health insurance compensation, a topic that has met discussions about the actual value of the compensation or the value of the expected income that the injured party or relatives should receive from social insurance. In the provisions related to the value of the compensation coverage, insurance laws and bylaws foresee certain limitations, not only in the method of calculating non-pecuniary  damages, but also with regard to the minimum amount of insurance coverage by the insurance companies. Referring to Albanian court practices there have been cases where there has been discrepancies in the calculation of biological damage between the insurance companies and the court.


2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Mig Irianto Legowo

<div class="page" title="Page 1"><div class="layoutArea"><div class="column"><p><span>Responsibility of Carriers for accident victims on the highway and how the process of providing compensation by PT Persero Raharja insurance services, as well as problems that arise in the maintenance of obtaining compensation insurance (compensation). The type of research used is normative juridical research type. The analytical method used is a qualitative normative data analysis method. The results of the study can be concluded: 1) Responsibility for the error of the Carrier is carried out as a family. While compensation for PT. (Pesero) Jasa Raharja's Loss Insurance is determined by the way of handling, namely by the way the victim or heir comes to Jasa Raharja's office to request the K1 form (for accidents hit by a motor vehicle) or K2 (for public passenger accidents), which is filled in correctly and fulfills conditions: information on road traffic accidents by the police, doctor's statement, and heir's statement if the victim dies and if the conditions are met correctly then the implementation of compensation will be able to run smoothly, provided it is guaranteed by Law No. 34 of 1964 jo. PP No. 18 of 1965. 2). The obstacles that exist in the implementation of Law No. 34 of 1964 concerning: Road Traffic Accident Funds are derived from victims or heirs of the victims in the form of community reluctance to take care of claims for compensation, this is due to the fear of dealing with authorities or state officials </span></p></div></div></div>


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