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A responsabilidade das operadoras de planos de saúde pelo fato do serviço prestado pelos hospitais credenciados / Health insurance companies responsibility for services rendered by credentialed hospitalsPupo, Juliana Labaki 04 June 2012 (has links)
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Previous issue date: 2012-06-04 / The present dissertation will present an overview about private health assistance in Brazil, having as its central theme the responsibility of Health Insurance Companies and credentialed Hospitals. It will be demonstrated the constitutional view, with the approach of the dignity principle of the human being, the main pillar of the right to health. The ways of health assistance provided by State will be discussed focusing on the activity rendered by private companies. The analysis of the context of Civil responsibility will be deepened, making a parallel between the subjective and objective responsibility, as well as a brief study on the transformation of the law in the post-modern society. Furthermore, it shall be detailed the legal nature of health insurance contracts and the applicability of the Consumer Defense Code , in which the objective responsibility by the risk of the supplier activity will prevail. The hospital activity and the extension of the health insurance companies responsibility for such services will also be discussed, considering that the hospital is chosen by the company, thus making a tripartite among ``Health Insurance Company-Hospital-Beneficiary´´. It shall be observed the sympathy among the suppliers, by demonstrating that the patient is supported by the laws of consumers protection and defense, aiming to guarantee full and effective assistance to their health / O presente estudo traça um panorama sobre a assistência privada à saúde no Brasil, tendo como tema central a responsabilidade das operadoras e dos hospitais credenciados. Será demonstrada a visão constitucional, com a abordagem do princípio da dignidade da pessoa humana, alicerce do direito à saúde. Serão mencionadas as formas de prestação de assistência à saúde pelo Estado, focando na atividade prestada pela iniciativa privada, por meio das operadoras. A análise do contexto da responsabilidade civil será aprofundada, traçando paralelo entre a responsabilidade subjetiva e objetiva, assim como um breve estudo sobre a transformação do Direito na sociedade pós-moderna. Em seguida, serão detalhadas a natureza jurídica do contrato de planos de saúde e a aplicabilidade do Código de Defesa do Consumidor às suas relações, em que prevalece a responsabilidade objetiva pelo risco da atividade do fornecedor. Também serão abordadas as atividades hospitalares e a extensão da responsabilidade da operadora por tal serviço, considerando que o hospital foi por ela escolhido, formando a relação tripartite entre Operadora-Hospital-Beneficiário . Observar-se-á a solidariedade entre os fornecedores, com a demonstração de que o paciente está amparado pelas leis de proteção e defesa do consumidor, com objetivo de garantir atendimento pleno e eficaz à sua saúde
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Koncepce optimalizace lůžkového fondu kraje Vysočina / The Concept of Optimalization of Hospital Bed Fund in the Vysočina RegionMlčák, Jan January 2011 (has links)
Thesis concentrates on theory and practical issues regarding hospital bed fund. In its theoretical part, the thesis describes reasons that lead to optimalization of hospital bed fund and methods used for calculation of suitable amount of hospital beds. In its practical part it focuses on a concept proposal of a hospital bed fund optimalization in the Vysočina region while calculating a minimal amount of hospital beds needed using deterministic methods arising from empiric formulas. This concept is then compared to already existing concept created by General Healthcare Insurance Company of the Czech Republic (in Czech: Vseobecna Zdravotni Pojistovna).
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金融海嘯期間公司治理與績效分析:台灣銀行業與壽險業探討 / Corporate governance and performance analysis in financial crisis:taiwan banking and insurance company吳姿瑩, Wu, Tzu Ying Unknown Date (has links)
本文以2007 年至2008 年金融海嘯期間,台灣公開發行之銀行與壽險業為對
象,研究公司治理與經營績效是否有顯著相關性,並進一步探討其與經營績效下跌程度是否有顯著相關,同時納入2004 年及2005 年檢測此現象是否僅於金融海嘯期間存在。本研究發現金融海嘯前與期間的公司治理變數顯著項目與經營績效不同,金融海嘯期間公司治理對其當年度經營績效有顯著影響,也與期間的受損程度有顯著影響,董監事報酬與經營機效呈現負相關;董事長兼任總經理呈現正相關,表示不論是在一般時期或是系統性風險下的事件發生時,金融業的公司治理機制會對企業經營表現具有攸關性。 / Using data from publicly-traded Taiwan banks and life insurance companies before and during the financial crisis, this study analyze the relation between corporate governance and the performance of Taiwan banking and life insurance company. In addition, to research the relation between corporate governance and the performance change ratio of Taiwan banking and life insurance company. Obviously,performance decreases during the crisis. Furthermore, We find negative relation between performance and ownership structure and compensation of board of directors, but positive relation between performance and dual. Finally, we find there are different relations before and during the financial crisis.
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投資營運中太陽能發電廠之評估研究 - 以H產險公司為例 / Assessment Research on Investing Operational Solar Power Station --- H Insurance CO., LTD.羅祥恩, Lo, Hsiang En Unknown Date (has links)
近幾年再生能源蓬勃發展,全球新增的太陽能發電裝置量也持續上升,擁有高太陽能技術的台灣,更是在太陽能電池上不停成長及擴張,使台灣在太陽能產業有高度前景。但由於太陽能成本高且產業鏈冗長,許多太陽能源公司紛紛想售出發電廠或尋求投資者。另一方面,國內保險業受到市場趨於飽和及利率偏低等因素影響,獲利難以成長,保險業的另一部份獲利來自於投資,穩定的投資獲利讓保險業者可以脫離低利率的險境,但由於台灣法令對保險業者的投資限制,使保險業者欠缺投資管道。基於營運中太陽能電廠需要資金,而保險業者需要新投資項目的情況下,如何讓保險業者更明白太陽能產業之營運方式及潛在風險,給予保險業者更明確的方向做為評估模式,將是本研究之重點。
投資績效的準確度有賴於評估模式的準確性,而評估模式的準確性則取決於影響因子之準確性。故要算出較為準確的投資績效,理解與抓出適當之影響因子為本研究的研究基礎。最後,本研究將太陽能電廠之營運風險評估方式分為「營收面」與「成本面」兩個面向,「營收面」中包含環境因素、系統因素與太陽光電躉購費率三大類的影響因子;「成本面」則包含投資成本、租金成本、維修與管理成本與清潔成本四類影響因子。由以上影響因子來評估一間營運中太陽能發電廠的價值,並以20年來計算內部投資報酬率(IRR)作為評判基準。 / Due to the rapidly growth in renewable energy nowadays, the quantity of solar power systems rises sustaining. Taiwan, which has high solar technology, is still expending its capability on solar power systems. It makes Taiwan have a bright prospect of solar industries. However, the high cost and lengthy industrial chain of solar industries let solar power companies try to sell out their power systems or find investments. On the other side, based on the domestic saturated market and low interest rates, insurance industries in Taiwan are hardly to earn profit on their operation. Another way for insurance companies to obtain profit is investment. Therefore, a stable investing profit makes insurance companies out of the low-rate situation. But due to the investment restriction in Taiwanese laws, insurance companies are always lack of investment projects. Based on the short of capital funds in solar power system and the lack of investment projects in insurance companies, how to let insurance companies know more on solar industries and their potential risks, and how to assessment solar power system will be the key point in this paper.
The accuracy of investment performance depends on accuracy of assessment model, and the accuracy of assessment model hinges on accuracy of impact factors. Therefore, in order to find an accurate investment performance, to realize and choose the appropriate impact factors will be the key process in this paper. Finally, to assess operational solar power station, this paper divided all the impact factors into two main categories: revenue and expense. Revenue includes 3 impact factors: environment factors, systems factors and feed-in tariff. Expense includes 4 impact factors: initial investment cost, rent expense, repair and managing cost and cleaning cost. According to these impact factors, we can assess the value of operational solar power station and evaluate internal rate of return (IRR) in 20 years.
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Varför väljs försäkringsbolag x? : en kvantitativ studie som analyserar vilka faktorer som förklarar försäkringstagares val av försäkringsbolagJohansson, Andreas, Torstensson, Oscar January 2014 (has links)
Den svenska försäkringsbranschen är gigantisk och det finns över 400 försäkringsbolag att välja mellan. Detta leder till hård konkurrens inom branschen, och försäkringsbolagen tvingas slåss om kunderna.Uppsatsens syfte är att analysera vilka försäkringsrelevanta faktorer som kan förklara försäkringstagares val av försäkringsbolag. Uppsatsen bygger på kvantitativ metod och en positivistisk infallsvinkel med en deduktiv ansats används.Uppsatsen indikerar att följande faktorer har positiv påverkan på försäkringstagare i valet av försäkringsbolag: Lågt pris på försäkringstjänsten, hög kvalitet på försäkringstjänsten, bra försäkringspersonal, lättåtkomligheten, starkt varumärke och banktjänstemäns påverkanEn medveten avgränsning som gjorts är att enbart fokusera på svenska privatpersoner, vilket lämnar utrymme för liknande forskning i ett globalt perspektiv. Ett förslag på fortsatt forskning är därför att analysera vilka faktorer som förklarar företags val av försäkringsbolag.Forskningen har varit begränsad inom försäkringsbranschen, såväl nationellt som internationellt. Mycket av tidigare forskning har fokuserat på befintliga kunder och hur de bibehålls. När det gäller vår inriktning är forskningen nästintill obefintlig. Vi hoppas att uppsatsen kan bidra med nyttig information till bland annat försäkringsbolag, då det torde vara av intresse för dem att veta vad som förklarar personers val av försäkringsbolag. / With more than 400 companies to choose between, the Swedish insurance sector is gigantic. The competition is fierce, and the insurance companies have to fight over customers and market shares. Our purpose with this dissertation is to analyze which insurance relevant factors determine which company the private consumer chooses. This dissertation has a quantitative research method, a positivistic philosophy and a deductive approach. Our study indicates that the following factors have a positive influence on insurers in their selection of insurance companies : Low price, high quality insurance service, professional staff, high accessibility and strong trademarks. Bank employees also tend to have influence on insurers in their selection of insurance companies. This study selectively focuses on the Swedish market, leaving room for further research in a global perspective. Additional research regarding companies selection of insurance companies may therefore be interesting. Research has traditionally focused on the existing customers, and how to keep them. In contrast, research concerning how people choose their insurance company has been limited, both nationally and internationally. We believe this dissertation may be of value for insurance companies because the knowledge of the factors may be important for attracting customers.
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Problematika pojistného podvodu v ČR / The insurance fraud issue in the Czech RepublicSvoboda, Lukáš January 2008 (has links)
The thesis is being concerned with one of the serious criminal acts causing each year damages worth hundrends of millions Czech crowns. The main aim of the thesis is to provide a complex view of the problems. The thesis analyses the issue from both legal and economic angle of view, deals with the insurance fraud typology and proves the theory by evidence of particular cases. The thesis thereinafter discovers causations of commiting insurance frauds and describes the insurence fraud abatment. In the end the thesis tries to disclose the weak points of the system of prevention, to point at them and to come up with the improvement suggestions and recommendations.
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投資組合集中度之研究 —以RBC架構下台灣保險公司之投資組合為例 / A study of portfolio concentration and performance of insurance company under RBC structure in Taiwan楊智皓, Yang, Chih Hao Unknown Date (has links)
截至2016年的統計資料,我國產險與壽險業的保險公司家數來到54家,保險業資產總額佔了全台灣所有金融機構總資產的31.78%,資產規模來到新台幣22.6兆元,在如此龐大的資產規模下,保險公司的投資組合管理變成相當的重要,重點漸漸的從投資在什麼樣的商品可以讓資金獲取最大效益轉移到了投資後的管理與部位的調整,以避免不必要的非系統性風險,有鑑於此,台灣在2003年實施了RBC制度,讓保險公司的投資組合的分配有所依據,不過仍然免不了過度集中在某些資產的問題,所以本研究的目的在於能否運用風險集中度的概念來判斷投資組合是否過度集中,而不僅僅只有投資金額的比例來做判斷。
本論文的研究方法會根據各家保險公司的實際投資組合以每半年或每年的型式分別計算Marginal Risk Contribution(MRC)的値,並且進行分析後再以Herfindahl-Hirschman Index(HHI)與 Gini Index 來檢視長期資產組合集中度的趨勢,最後的研究結果可以發現若是從邊際風險貢獻的比例來看,各保險公司的風險分布主要是集中在國內上市普通股與ETF、海內外不動產投資、國外已開發國家或新興市場上市普通股與ETF以及A評等的國外固定收益債券,而利用HHI與Gini Index兩個指標來看,各保險公司的資產集中度是逐年上升的。 / According to the statistical data in 2016, there are 54 insurance companies which includes property and casualty insurance company and life insurance company. And the scale of insurance asset is NTD 2,260 billion, accounting for 31.78% of whole asset of financial institution in Taiwan. Under huge amount of asset, the portfolio management for insurance company become more and more important. The key points of this issue are transferring to the ratio of portfolio management from choosing asset class to get maximum profit in order to avoid the nonsystematic risk gradually. Therefore, the Risk-based Capital policy has established in 2003 in Taiwan. The ratio of the insurance companies’ portfolio had the reference to allocate. However, there were some issues about the excessive concentration of some asset classes. So, the target of this study is using the concept of the risk concentration to judge the portfolio too concentrated or not. Not just judge it by its amount invested.
The research process of this thesis is to calculate the marginal risk contribution value of the insurance companies’ portfolio every half a year or every year. Moreover, using the Herfindahl-Hirschman Index (HHI) & Gini Index to observe the trend of long term portfolio concentration. From the marginal risk contribution ratio. We can found the result of this study is the risk concentrated on the domestic listed common stock & ETF, domestic or foreign Real Estate, foreign developed market or emerging market listed common stock & ETF and fixed income bond (A rating). Besides, using the Herfindahl – Hirschman index and Gini index. The concentrated ratio of insurance companies’ portfolio were raising recent years.
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Balancing Act: Successfully Combining Creativity and Accountability in the Practice of Marriage and Family TherapyBello, Nathalie Duque 01 January 2015 (has links)
The conditions that allowed early MFTs the freedom to creatively explore different interventions and theories of change are no longer available in today’s mental health care system. Although there are many benefits to the structure of managed behavioral healthcare organizations, a thorough review of the literature demonstrates that many therapists working in managed care agencies struggle with maintaining their theoretical creativity, claiming third-party payers’ service requirements and paperwork a barrier to their creativity. A phenomenological transcendental research method was utilized to understand the phenomenon of successfully combining creativity and accountability in the practice of marriage and family therapy from the perspective of six creative MFTs who have effectively incorporated creative therapeutic techniques into their work, while adhering to the structured requirements of managed care.
The findings and themes of the study were organized into two categories. The themes in the Textural / Content Category (description and purpose of therapeutic creativity at a managed care agency) are: (1) Creatively combining the needs of the clients, the different professional entities, insurance companies and you as a therapist, (2) Translating post-modern information into the medical model language that meets the third-party payers’ requirements, (3) Completing documentation with clients, (4) Incorporating technique from a range of therapy models, (5) Keeping clients engaged through a variety of resources and activities, and (6) Utilizing metaphors and themes to uncover patterns of relational dynamics and behaviors. The themes in the Structural / Supportive Conditions Category (factors that allow the balance of creativity and accountability to occur) are: (1) Systemic understanding of how the therapeutic and business systems of managed behavioral healthcare interact together, (2) Having a supportive network of colleagues, (2a) Supportive group of coworkers within the job setting, (2b) Supportive network of MFT colleagues outside of the work setting, (3) Desire to make a difference in peoples’ lives, (4) Continuous education on all aspects of the mental health field, (5) Employers’ support of creative therapy, (6) Self-reflection, (7) Self-care, and (8) Organization and time management.
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Inovace vybraných pojistných produktů a jejich alternativ / Innovation of Selected Insurance Products and their AlternativesKolouchová, Jana January 2018 (has links)
The diploma thesis deals with innovations selected insurance products and their alternatives. The theoretical part describes the insurance market and development of insurance in the Czech Republic, defines important terms as a coincidence, insured event, insurance products, risk and legal norms in the insurance. In the practical part is an analysis of the selected insurance company and its competitors. On the basis of obtained information are selected insurance products compared. In the proposal part are recommended changes for existing insurance products of the selected insurance company in terms of their content and coverage of risk in the unexpected event. The partial aim is the proposal an alternative insurance product for selected insurance company, which could arise in the future in its range of insurance products.
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Návrh na zlepšení nabídky vybraného pojistného produktu společnosti Allianz pojišťovna a.s. / An improvement suggestion for the offer of a concrete insurable product in Allianz insurancHliněná, Martina January 2007 (has links)
Thesis deals with analysis of the life child's insurance product of company Allianz pojišťovna a.s. and its comparsion with offer of chosen commercial insurance companies. The thesis result is a proposal for improvement of this company´s life child's insurance product offer.
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