Thesis (M.A.)--City University of Hong Kong, 2005. / "Dissertation submitted to the School of Law in partial fulfillment of the requirements for the degree of Master of arts in arbitration & dispute resolution." Title from title screen (viewed on Mar. 27, 2006) Includes bibliographical references.

Thesis (M.A.)--City University of Hong Kong, 2007. / Title from PDF t.p. (viewed on Sept. 7, 2007) "Master of Arts in arbitration and dispute resolution 2006-2007, LW 6409 dissertation" Includes bibliographical references.

Please read the abstract in the section 00front of this document / Dissertation (MOcc (Occupational Therapy))--University of Pretoria, 2005. / Occupational Therapy / unrestricted

This thesis deals with the enforcement of claims coming from public health insurance by VZP ČR. The work is divided into theoretical and practical part. The theoretical part describes the reasons for the claims on public health insurance, their findings through the administrative procedure and the legal possibilities of enforcement. It also contains a description of the bankruptcy and criminal proceedings. In the practical part is an analysis of enforcement of claims by VZP ČR from 2012 to 2015. The work also includes the definition of the organizational structure of the VZP ČR. In the final part of the thesis we identified shortcomings in the current working with claims by the VZP ČR.

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. / Business, Sauder School of / Graduate

京都大学 / 新制・課程博士 / 博士(医学) / 甲第23758号 / 医博第4804号 / 新制||医||1056(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 今中 雄一, 教授 川上 浩司, 教授 小濱 和貴 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

Despite the wide spread use of psychological instruments in the forensic context, there is a dearth of research on the purposes for using it. A qualitative case study approach was adopted in this study to explore the purposes for which industrial psychologists use psychological instruments in loss of income claims. The research study comprised of two phases. Firstly, a literature review was used to provide some background on psychological assessment in the forensic context. The literature review described the historical development of forensic psychology, what psychological instruments are and how they are used in the forensic context. The forensic context, in which industrial psychologists operate, was also described. Furthermore, the initial conceptual framework to outline the context of the next phase of the research was illustrated. The second phase was an exploratory study that made use of a multiple-case study approach. The main research aim was to explore the purposes for using psychological instruments in loss of income claims by industrial psychologists. Another aim was to explore the psychological instruments used. The final aim was to explore the kind of information that is needed in the forensic context, which is not currently available by means of existing psychological assessment. Case study data was collected by conducting semi-structured interviews with four industrial psychologists. Each interview represented a case to be analysed. The multiple-case study data gathered were then analysed using coding, within-case analysis and across-case analysis. The findings indicate that psychological instruments are used for the following purposes: (1) to add value to the quantification of a loss of income claim; and (2) to provide information that is required on the specific situation and circumstances surrounding the claim. Furthermore, the research findings also revealed that the purpose of using a psychological instrument to add value is influenced by internal factors of the psychological instrument as well as situational characteristics of the legal matter at hand. Through the exploration of the purposes for using psychological instruments, specific instruments used could be identified. Another finding included the existence of a perception that the psychological instruments currently available in South Africa are inadequate to provide the information required in the forensic context. The findings also revealed the kind of information that is needed.Recommendations were made for future research and industry-related practices. / Industrial and Organisational Psychology / M.Comm. (Industrial and Organisational Psychology)

Despite the wide spread use of psychological instruments in the forensic context, there is a dearth of research on the purposes for using it. A qualitative case study approach was adopted in this study to explore the purposes for which industrial psychologists use psychological instruments in loss of income claims. The research study comprised of two phases. Firstly, a literature review was used to provide some background on psychological assessment in the forensic context. The literature review described the historical development of forensic psychology, what psychological instruments are and how they are used in the forensic context. The forensic context, in which industrial psychologists operate, was also described. Furthermore, the initial conceptual framework to outline the context of the next phase of the research was illustrated. The second phase was an exploratory study that made use of a multiple-case study approach. The main research aim was to explore the purposes for using psychological instruments in loss of income claims by industrial psychologists. Another aim was to explore the psychological instruments used. The final aim was to explore the kind of information that is needed in the forensic context, which is not currently available by means of existing psychological assessment. Case study data was collected by conducting semi-structured interviews with four industrial psychologists. Each interview represented a case to be analysed. The multiple-case study data gathered were then analysed using coding, within-case analysis and across-case analysis. The findings indicate that psychological instruments are used for the following purposes: (1) to add value to the quantification of a loss of income claim; and (2) to provide information that is required on the specific situation and circumstances surrounding the claim. Furthermore, the research findings also revealed that the purpose of using a psychological instrument to add value is influenced by internal factors of the psychological instrument as well as situational characteristics of the legal matter at hand. Through the exploration of the purposes for using psychological instruments, specific instruments used could be identified. Another finding included the existence of a perception that the psychological instruments currently available in South Africa are inadequate to provide the information required in the forensic context. The findings also revealed the kind of information that is needed.Recommendations were made for future research and industry-related practices. / Industrial and Organisational Psychology / M.Comm. (Industrial and Organisational Psychology)

A company issuing an insurance will provide, in return for a monetary premium, acceptance of the liability to make certain payments to the insured person or company if some beforehand specified event occurs. There will always be a delay between occurrence of this event and actual payment from the insurance company. It is therefore necessary for the company to put aside money for this liability. This money is called the reserve. When a claim is reported, a claim handler will make an estimate of how much the company will have to pay to the claimant. This amount is booked as a liability. This type of reserve is called; "case reserve". When making the estimate, the claim handler has the option of giving the claim a standard reserve or a manual reserve. A standard reserve is a statistically calculated amount based on historical claim costs. This type of reserve is more often used in small claims. A manual reserve is a reserve subjectively decided by the claim handler. This type of reserve is more often used in large claims. This thesis propose a theory to model and calculate an optimal limit above which a claim should be considered large. An application of the method is also applied to some different types of claims.

The theme of my work is " The adjustment of claims in life insurance". In the theoretical part I focus on the characteristics of adjustment of claims, legislation, claims adjuster and the importance of adjustment of claims. In the second part I describe life insurance and its position in the insurance business in the Czech Republic. In the last part I engage adjustment of claims process in life insurance in Allianz insurance company. At the end of this part I describe specific examples of adjustment of claims. These examples show, that the claims adjusters meet the diferent situations, which need an individual approach.