This thesis is focused on the claims in company Jetcon Ltd. Today is no company which would not have to manage and analyze claims. Construction sector is a field where there is currently a very tough competition. What are the Jetcon Ltd claims? What is their structure and amount? How the company deals with and prevents irrecoverable claims? These are some of the questions that this thesis is responsible.

This research project focuses on how three different levels of naval power influence the occurrence of militarized disputes over maritime claims. First, the systemic level of naval power investigates the role of the leviathan (the naval hegemon: the United States since World War II). As proponents of the hegemonic stability argue, the overwhelming naval power of the naval hegemon leads to stability in the sea by deterring the number of militarized disputes over maritime claims because more naval warships of the naval hegemon mean that more naval warships can operate in the sea to prevent maritime conflicts. However, when considering the vast area of the sea and the limited number of naval warships of the United States, it is impossible to deploy an equal number of naval warships to all maritime areas. As a rational actor, the naval hegemon should put more effort to more salient maritime claims. In other words, the naval hegemon should pay more attention to maritime claims which are highly related to its security/economic interests. Among several factors, this research found that when maritime claims are strategically important, which means maritime claims occur near international straits, and when maritime claimants are jointly democratic, the pacifying effect of the naval hegemon is increased. Second, at the regional level of naval power, which focuses on Asia, the Asian naval hegemon has played a similar role as the global naval hegemon has done to maintain the order and to deter militarization over the sea. However, the Asian naval hegemon has a different level of incentive to align with the global naval hegemon’s effort depending on the relationships with the global naval hegemon. The results show that when the Asian naval hegemon is allied with the global naval hegemon and when the Asian naval hegemon is a democracy, the Asian naval hegemon is more likely to cooperate with the global naval hegemon’s effort to maintain stability in the regional waters, which results in fewer militarized disputes over maritime claims in Asia. In addition, this study also found that when the Asian naval hegemon approaches naval power of the global naval hegemon in Asia, they are more likely to challenge the order and the rules formed by the global naval hegemon, which leads to more conflictual behaviors over Asian maritime claims. Lastly, at the dyadic level of naval power, this research focuses on how relative naval power between claimants affects foreign policy over maritime claims. When disputants over maritime claims have projectable naval power, they can conduct more active and aggressive foreign policy, which can lead to militarization over maritime claims. However, when claimants consider foreign policy over maritime claims, they should consider the strength of naval power relative to the opponent. Similar to the power (dis) parity argument, the results show that parity of relative naval power between claimants increases the occurrence of militarized disputes over maritime claims.

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The process dealing with the resolution of Treaty claims considers a lot of information pertaining to real-world resources - spatial information. This study seeks to identify and suggest solutions for spatial information problems within the present claims process. This leads to a formal systems model of the present claims process emphasising the use of spatial information. An informal understanding of the claims process is then formed by analysing perceptions of actors within the claims process, thus allowing spatial information problems to be identified. Further analysis of the spatial information problems identifies causes, enabling possible solutions to be developed. Lastly, a solution is proposed and discussed as a means of highlighting other possible solutions to the spatial information problems identified by the study.

Due to the inherent risks and increasing complexity of modern construction projects, delays and cost overruns have become common facts in the industry. Researchers and practitioners have used many techniques to assess project delays and apportion delay responsibility among the parties involved. Windows delay analysis has been recognized as one of the most credible techniques for analyzing construction delays. Despite its benefits, windows analysis can produce different results depending on the window size, it does not consider owner and contractor acceleration, it does not systematically consider the impact of several baseline updates made due to changes in the duration and logical relationships of the activities, and it does not consider the impact of the progress events on resource over-allocation and its consequent delays. This study proposes a computerized schedule analysis model that considers multiple baseline updates and resource over-allocation. The model uses a daily window size in order to consider all fluctuations in the critical path(s) and uses a legible representation of progress information to accurately apportion delays and accelerations among project parties. To facilitate its use, the model has been incorporated into a computer tool, EasyPlan, which integrates estimating, scheduling, resource management, and project control. A simple case study has been implemented on the proposed delay analysis model in order to demonstrate its accuracy and usefulness.

Due to the inherent risks and increasing complexity of modern construction projects, delays and cost overruns have become common facts in the industry. Researchers and practitioners have used many techniques to assess project delays and apportion delay responsibility among the parties involved. Windows delay analysis has been recognized as one of the most credible techniques for analyzing construction delays. Despite its benefits, windows analysis can produce different results depending on the window size, it does not consider owner and contractor acceleration, it does not systematically consider the impact of several baseline updates made due to changes in the duration and logical relationships of the activities, and it does not consider the impact of the progress events on resource over-allocation and its consequent delays. This study proposes a computerized schedule analysis model that considers multiple baseline updates and resource over-allocation. The model uses a daily window size in order to consider all fluctuations in the critical path(s) and uses a legible representation of progress information to accurately apportion delays and accelerations among project parties. To facilitate its use, the model has been incorporated into a computer tool, EasyPlan, which integrates estimating, scheduling, resource management, and project control. A simple case study has been implemented on the proposed delay analysis model in order to demonstrate its accuracy and usefulness.

The concept of social membership is the mainframe for this dissertation, which encompasses four independent articles that approach the boundaries of social membership from different perspectives. Empirically, the focus lies on mobilizing groups that demand an extension of rights and/or inclusion for documented and undocumented immigrants in two European immigration countries: Sweden and Spain. I have defined the processes through which mobilizing actors (immigrants themselves and diverse supporters of their cause) interact with boundary-making actors (institutional actors, policy makers), whom through their positions participate in drawing the boundaries between inclusion and exclusion, as negotiating social membership. To study these processes, I have performed 68 interviews with actors as mobilizing immigrants, activists mobilizing on behalf of immigrants, representatives of NGOs and trade unions, policy-makers and politicians. Two main types of claims appeared: undocumented migrants’ rights groups mobilizing for residence permits and social rights, and documented immigrants’ (and their supporters’) advocacy against ethnic discrimination. Furthermore, I have included a study that reflects the tensions over social membership within immigrant communities. The gendered dimension is its main focus, as it illustrates the value conflicts over gender equality and ethnic diversity brought to the surface through the debates following so-called honour killings in Sweden, and the difficulties faced by young immigrant women mobilizing simultaneously against racism and patriarchal oppression.  The thesis consists of four independent articles within the overall framework of mobilizing groups demanding extended rights for and/or inclusion of immigrants. By using immigrants’ rights mobilizations, negotiations, debates and agendas, my general aim has been to explore the processes through which social membership is being contested and negotiated by a wide range of actors. In doing so, it has been possible to reveal how legal and symbolic boundaries create exclusionary processes that pose constraints on the social membership of immigrants with different legal statuses. / <p>At the time of the doctoral defense, the following paper was unpublished and had a status as follows: Paper 1: Manuscript.</p>

published_or_final_version / abstract / toc / Statistics and Actuarial Science / Master / Master of Philosophy

The goal of the project was to use the data in the Workers' Compensation Board (WCB) of British Columbia's data warehouse to develop a statistical model that could predict on an ongoing basis those short-term disability (STD) claims that posed a potential high financial risk to the WCB. We were especially interested in identifying factors that could be used to model the transition process of claims from the STD stratum to the vocational rehabilitation (VR) and long term disability (LTD) strata, and forecast their financial impact on the WCB. The reason for this focus is that claims experiencing these transitions represent a much higher financial risk to the WCB than claims that only progress to the health care (HC) and/or the short term disability (STD) strata. The sample used to investigate the conversion processes of claims consists of all STD claims (323,098) that had injury dates between January 1, 1989 and December 31, 1992. Although high-risk claims represent only 4.2 % of all STD claims, they have received 64.3% ($1.2 billion) of the total payments and awards ($1.8 billion) made to July 1999. Low-risk claims make up 95.8% of all the claims but only receive 35.7% ($651 million) of the payments and awards. Moreover, the average cost of high-risk claims ($86,200) is 41 times higher than the average cost of low-risk claims ($2,100). The main objective of the project was to build a reliable statistical model to identify high-risk claims that can be readily implemented at the WCB and thereby improve business decisions. To identify high-risk claims early on, we used logistic regression modeling. Since ten of the most frequently observed injury types make up 95.72% of all the claims, separate logistic regression models were built for each of them. Besides injury type, we also identified STD days paid and age of claimant as statistically significant predictors. The logistic regression models can be used to identify high-risk claims prior to or at the First Final STD payment date provided we know the injury type, STD days paid and age of claimant. The investigation showed that the more STD days paid and the older the injured worker, the higher the probability of the claim being high-risk.

A dissertation presented to the Faculty of Health, Durban University of Technology, for the Masters Degree in Technology: Chiropractic, 2009. / Background: The International Classification of Diseases (ICD) provides codes to classify diseases in such a manner, that every health condition is assigned to a unique category. Some of the most common diagnoses made by chiropractors are not included in the ICD-10 coding system, as it is mainly medically orientated and does not accommodate these diagnoses. This can potentially lead to reimbursement problems for chiropractors in future and create confusion for medical aid schemes as to what conditions chiropractors actually diagnose and treat. Aim: To determine the level of compliancy of chiropractors, in South Africa, to the ICD-10 coding procedure and the factors that may influence the use of correct ICD-10 codes. As well as to determine whether the ICD-10 diagnoses chiropractors commonly submit to the medical aid schemes, reflect the actual diagnoses made in practice. Method: The study was a retrospective survey of a quantitative nature. A self-administered questionnaire was e-mailed and posted to 380 chiropractors, practicing in South Africa. The electronic questionnaires were sent out four times at two week intervals for the duration of eight weeks; and the postal questionnaires sent once. A response rate of 16.5% (n = 63) was achieved. Raw data was received from the divisional manager of the coding unit of Discovery Health (Pty) Ltd. in the form of an excel spreadsheet containing the most common ICD-10 diagnoses made by chiropractors in South Africa, for the period June 2006 to July 2007, who had submitted claims to the Medical Scheme. The spreadsheet also contained depersonalised compliance statistics of chiropractors to the ICD-10 system from July 2006 to October 2008. SPSS version 15 was used for descriptive statistical data analysis (SPSS Inc., Chicago, Ill, USA). Results: The age range of the 63 participants who responded to the questionnaire was 26 to 79 years, with an average of 41 years. The majority of the participants were male (74.6%, n = 47). KwaZulu-Natal had 25 participants (39.6%), Gauteng 17 (26.9%), Western Cape 12 (19%), Eastern Cape four (6.3%), Free State and Mpumalanga two (3.1%) each and North West one (1.5%). The mean knowledge score for ICD-10 coding was 43.5%, suggesting a relatively low level of knowledge. The total percentage of mistakes for electronic claims was higher for both the primary and unlisted claims (3.93% and 2.18%), than for manual claims iv (1.57% and 1.59%). The total percentage of mistakes was low but increased marginally each year for both primary claims (1.43% in 2006; 1.99% in 2007; 2.33% in 2008) and unlisted claims (0% in 2006; 2.61% in 2007; 3.07% in 2008). CASA members were more likely to be aware of assistance offered, in terms of ICD-10 coding through the medical schemes and the association (p = 0.131), than non-members. There was a non-significant trend towards participants who had been on an ICD-10 coding course (47.6%; n = 30), having a greater knowledge of the ICD-10 coding procedures (p = 0.147). Their knowledge was almost 10% higher than those who had not been on a course (52.4%; n = 33). Most participants (38.1%; n = 24) did not use additional cause codes when treating cases of musculoskeletal trauma, nor did they use multiple codes (38.7%; n = 24) when treating more than one condition in the same patient. Nearly 70% of participants (n = 44) used the M99 code in order to code for vertebral subluxation and the majority (79.4%; n = 50) believed the definition of subluxation used in ICD-10 coding to be the same as that which chiropractors use to define subluxation. According to the medical aid data, the top five diagnoses made by chiropractors from 2006 to 2007 were: Low back pain, lumbar region, M54.56 (8996 claims); Cervicalgia, M54.22 (6390 claims); Subluxation complex, cervical region, M99.11 (2895 claims); Other dorsalgia, multiple sites in spine, M54.80 (1524 claims) and Subluxation complex, sacral region, M99.14 (1293 claims). According to the questionnaire data, the top five diagnoses (Table 4.24) were: Lumbar facet syndrome, M54.56 (25%); Lumbar facet syndrome, M99.13 (23.3%); Cervical facet syndrome, M99.11 (21.7%); Cervicogenic headache, G44.2 (20%) and Cervicalgia, M54.22 (20%). Conclusion: The sample of South African chiropractors were fairly compliant to the ICD-10 coding system. Although the two sets of data (i.e. from the medical aid scheme and the questionnaire) regarding the diagnoses that chiropractors make on a daily basis correlate well with each other, there is no consensus in the profession as to which codes to use for chiropractic specific diagnoses. These chiropractic specific diagnoses (e.g. facet syndrome) are however, the most common diagnoses made by chiropractors in private practice. Many respondents indicated that because of this they sometimes use codes that they know will not be rejected, even if it is the incorrect code. For more complicated codes, the majority of respondents indicated that they did not know how to or were not interested in submitting the correct codes to comply with the level of specificity required by the medical aid schemes. The challenge is to make practitioners aware of the advantages of correct coding for the profession.