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Journal articles on the topic 'Unpaid claims'
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1
SFIKAS, PETER M. "Stress, strain and unpaid claims." Journal of the American Dental Association 135, no. 7 (July 2004): 1031–33. http://dx.doi.org/10.14219/jada.archive.2004.0344.
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Meng, Shengwang, and Guangyuan Gao. "COMPOUND POISSON CLAIMS RESERVING MODELS: EXTENSIONS AND INFERENCE." ASTIN Bulletin 48, no. 3 (May 11, 2018): 1137–56. http://dx.doi.org/10.1017/asb.2018.12.
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AbstractWe consider compound Poisson claims reserving models applied to the paid claims and to the number of payments run-off triangles. We extend the standard Poisson-gamma assumption to account for over-dispersion in the payment counts and to account for various mean and variance structures in the individual payments. Two generalized linear models are applied consecutively to predict the unpaid claims. A bootstrap is used to estimate the mean squared error of prediction and to simulate the predictive distribution of the unpaid claims. We show that the extended compound Poisson models make reasonable predictions of the unpaid claims.
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Polontoh, Herry. "Legal Responsibility of the Insurance Company for Unpaid Participant Claims." Journal of World Science 3, no. 1 (January 31, 2024): 105–10. http://dx.doi.org/10.58344/jws.v3i1.541.
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Insurance is a financial institution that has a vital role in the economy. Insurance protects the public from various risks, such as accidents, illness, and death. The insurance company must pay claims to insurance participants who experience losses in an insurance agreement. However, in practice, claims are often rejected by insurance companies. The purpose of this research is to analyze the legal responsibility of insurance companies for unpaid participant claims. This research uses normative legal research methods. Research data was obtained through a literature study. Research data was analyzed qualitatively using descriptive analysis methods. The research results show that insurance companies that reject insurance participants' claims can be subject to civil and criminal legal responsibility. If the participant's claim is not paid, the participant can file for bankruptcy through court. The regulations that provide the legal umbrella for protecting insurance participants consist of Law Number 8 of 1999 concerning Consumer Protection, Law Number 40 of 2014 concerning Insurance, Decree of the Minister of Finance No. 422/KMK.06/2003 concerning the Implementation of Insurance Business and Reinsurance Companies, and Financial Services Authority Regulation Number 23/POJK.05/2015 concerning Insurance Products and Marketing of Insurance Products. Legal protection for insurance policyholders as consumers are regulated in the Insurance Law and the Consumer Protection Law.
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Brysiewicz, Krzysztof. "Recovery of unpaid funding by beneficiaries of EU funds." Eastern European Journal of Transnational Relations 7, no. 1 (2023): 5–17. http://dx.doi.org/10.15290/eejtr.2023.07.01.01.
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The purpose of the article is to analyze the issue of pursuing claims for payment by beneficiaries of EU funds. The author analyzed the jurisprudence of Polish courts in cases concerning EU funds, as well as literature devoted to these issues. Based on the article, the issue of legal bases of beneficiaries' claims related to the refusal to pay EU funds on the basis of co-financing agreements is analyzed. Attention was drawn to the important role of compensation and payment proceedings as legal instruments enabling the fulfilment of the Member State's tasks in the prevention of irregularities. The issue of the possibility of treating unpaid funding as damage in the sense of lost profits was also analyzed. The article discusses the grounds of causation between the improper operation of the institution refusing to pay the subsidy and the damage suffered by the beneficiaries. Beneficiaries on the basis of a co-financing agreement may pursue both claims for payment, i.e. for performance of the service, as well as claims for damages. Claims for damages require proof of damage and a causal link between the unlawful act of the institution and the damage. Damage may also be an amount equivalent to the value of the grant that the beneficiary would have obtained if it had not been for the improper performance of the contract by the institution.
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Lopez, Olivier, Xavier Milhaud, and Pierre-E. Thérond. "A TREE-BASED ALGORITHM ADAPTED TO MICROLEVEL RESERVING AND LONG DEVELOPMENT CLAIMS." ASTIN Bulletin 49, no. 03 (May 7, 2019): 741–62. http://dx.doi.org/10.1017/asb.2019.12.
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AbstractIn non-life insurance, business sustainability requires accurate and robust predictions of reserves related to unpaid claims. To this aim, two different approaches have historically been developed: aggregated loss triangles and individual claim reserving. The former has reached operational great success in the past decades, whereas the use of the latter still remains limited. Through two illustrative examples and introducing an appropriate tree-based algorithm, we show that individual claim reserving can be really promising, especially in the context of long-term risks.
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Lambert, Stephanie. "Toxic Waste and Unpaid Labor." Twentieth-Century Literature 67, no. 2 (June 1, 2021): 109–38. http://dx.doi.org/10.1215/0041462x-9084302.
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“Everyday things represent the most overlooked forms of knowledge,” claims Father Paulus, the Jesuit priest in Don DeLillo’s novel Underworld (1997). What tends to go overlooked in DeLillo’s work, this article proposes, is the socio-ecological violence of the capitalist world-system that undergirds this “everyday.” Turning to DeLillo’s depiction of the Cold War kitchen in Underworld (1997) and consumerist detritus in White Noise (1985), this article reveals how the novels foreground the exploited labor and land required to sustain accumulation and the toxic consequences of the US cycle. To do so, it brings into dialogue critiques of everyday life; the Warwick Research Collective’s definition of “world-literature” as “the literary registration of . . . combined and uneven development”; Jason W. Moore’s world-ecological analysis with Marx’s theory of value; and Silvia Federici, Maria Mies, and Nancy Fraser’s Marxist-feminist analyses of domestic labor.
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Swayne, Lawrence C., Alan Fask, Helen D. Stelletell, John D. Fanburg, Lynn Griffin, and Jonathan H. Sunshine. "Unpaid Radiology Claims in New Jersey: Incidence and Financial Implications." American Journal of Roentgenology 183, no. 1 (July 2004): 3–7. http://dx.doi.org/10.2214/ajr.183.1.1830003.
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Canady, Valerie A. "Arizona providers plagued with unpaid claims, layoffs after BH transition." Mental Health Weekly 29, no. 5 (February 4, 2019): 1–3. http://dx.doi.org/10.1002/mhw.31759.
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Kelly, Carly. "Healthcare Reimbursement: HMO Arbitration Clause Enforced." Journal of Law, Medicine & Ethics 31, no. 4 (2003): 731–34. http://dx.doi.org/10.1111/j.1748-720x.2003.tb00142.x.
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In Pacificare Health Systems, Inc. v. Jefrey Book, the US. Supreme Court ruled that the mandatory arbitration clause in an HMO contract should be enforced to compel a physician to arbitrate his RICO charges against the health plan, even though the clause could be construed to limit the arbitrator’s authority to award full damages under the RICO statute. The ruling could prevent physicians with health plan arbitration agreements from taking future reimbursement claims against insurance companies directly to court, even when the allegations involve a potential statutory breach outside of the explicit scope of the provider contract.Dr. Book’s arbitration claim was part of a larger class action lawsuit filed in August of 2000 by a group of physicians and patients seeking reimbursement from eight managed care companies for unpaid health insurance claims.
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Waters, Teresa M., David M. Studdert, Troyen A. Brennan, Eric J. Thomas, Orit Almagor, Martha Mancewicz, and Peter P. Budetti. "Impact of the National Practitioner Data Bank on Resolution of Malpractice Claims." INQUIRY: The Journal of Health Care Organization, Provision, and Financing 40, no. 3 (August 2003): 283–94. http://dx.doi.org/10.5034/inquiryjrnl_40.3.283.
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Policymakers and commentators are concerned that the National Practitioner Data Bank (NPDB) has influenced malpractice litigation dynamics. This study examines whether the introduction of the NPDB changed the outcomes, process, and equity of malpractice litigation. Using pre- and post-NPDB analyses, we examine rates of unpaid claims, trials, resolution time, physician defense costs, and payments on claims with a low/high probability of negligence. We find that physicians and their insurers have been less likely to settle claims since introduction of the NPDB, especially for payments less than $50,000. Because this disruption appears to have decreased the proportion of questionable claims receiving compensation, the NPDB actually may have increased overall tort system specificity.
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Kitley, Molly, Hadley Johnson, Adam Spooner, Maria Hordinsky, and Ronda Farah. "27934 Unpaid insurance claims associated with the treatment of alopecia areata and lichen planopilaris." Journal of the American Academy of Dermatology 85, no. 3 (September 2021): AB168. http://dx.doi.org/10.1016/j.jaad.2021.06.686.
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Bakewell, F., S. Addleman, and V. Thiruganasambandamoorthy. "P010: Use of the emergency department by refugees under the Interim Federal Health Program." CJEM 18, S1 (May 2016): S81—S82. http://dx.doi.org/10.1017/cem.2016.187.
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Introduction: In June 2012, the federal government made cuts to the Interim Federal Health (IFH) Program that reduced or eliminated health insurance for refugee claimants in Canada. The purpose of this study was to examine the effect of the cuts on emergency department (ED) use among patients claiming IFH benefits. Methods: We conducted a health records review at two tertiary care EDs in Ottawa. We reviewed all ED visits wherein an IFH claim was made at triage, for 18 months before and 18 months after the changes to the program on June 30, 2012 (2011-2013). Claims made before and after the cuts were compared in terms of basic demographics, chief presenting complaints, acuity, diagnosis, presence of primary care, and financial status of the claim. Results: There were a total of 612 IFH claims made in the ED from 2011-2013. The demographic characteristics, acuity of presentation and discharge diagnosis were similar during both the before and after periods. Overall, 28.6% fewer claims were made under the IFH program after the cuts. Of the claims made, significantly more were rejected after the cuts than before (13.7% after vs. 3.9% before, p<0.05). The majority (75.0%) of rejected claims have not been paid by patients. Fewer patients after the cuts indicated that they had a family physician (20.4% after vs. 30% before, p<0.05) yet a higher proportion of these patients were still advised to follow up with their family doctor during the after period (67.2% after vs. 41.8% before, p<0.05). Conclusion: A higher proportion of both rejected and subsequently unpaid claims after the IFH cuts in June 2012 represents a potential barrier to emergency medical care, as well as a new financial burden to be shouldered by patients and hospitals. A reduction in IFH claims in the ED and a reduction in the number of patients with access to a family physician also suggests inadequate care for this population. Yet, the lack of primary care was not reflected in the follow-up advice offered by ED physicians to patients.
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Kompatsiaris, Panos. "Art Struggles: Confronting Internships and Unpaid Labour in Contemporary Art." tripleC: Communication, Capitalism & Critique. Open Access Journal for a Global Sustainable Information Society 13, no. 2 (September 30, 2015): 554–66. http://dx.doi.org/10.31269/triplec.v13i2.613.
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This article explores the practices of recently formed and mainly UK-based art workers’ collectives against unpaid internships and abusive work. The modes through which these collectives perform resistance involve activist tactics of boycotting, site-specific protests, counter-guides, and whistleblowing and name and shame approaches mixed with performance art and playful interventions. Grappling with the predicaments of work in contemporary art, a labouring practice that does not follow typical processes of valorization and has a contingent object and an extremely loose territorial unity, this article argues that while the identity of the contemporary artist is systemically and conceptually moving towards fluidity and open-endedness, these groups work to reaffirm a collective in whose name it is possible to advance certain claims, assumptions, and demands. The contradictions and dynamics of art workers organizing against internships and voluntary work within a highly individualized, self-exploitative, and often privileged field are useful for informing labour organizing in the framework of ongoing capitalist restructuring.
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Radovanović, Vladimir. "Legal regime for the protection of employees' claims in the case of employer's bankruptcy in the Republic of Serbia." Pravo - teorija i praksa 40, no. 3 (2023): 94–114. http://dx.doi.org/10.5937/ptp2303094r.
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When bankruptcy proceedings are initiated by an employer, that often leads to uncertainty and problems for its employees. One of the biggest problems in this kind of situation is the protection of employees' claims arising from the employment relationship. Employees have the right to the payment of their claims arising from the employment relationship, such as unpaid wages, transportation allowances, meal allowances, holiday bonuses and the alike. However, in the case of the employer's bankruptcy, these claims are at risk, and there is a possibility that employees may not be able to fully collect them, which compromises the fundamental principles of labor legislation. For this reason, the state intervenes to protect monetary claims arising from employment. The primary mechanism involves granting privileged creditor status with priority claims, along with mechanisms to protect these claims through a special guarantee institution. If there was no such intervention by the state, the realization of those rights would be difficult. However, even with state intervention, the realization of these rights is not guaranteed. In this regard, this paper will examine models for protecting employees' claims in the event of bankruptcy, while identifying practical problems in this field.
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Gundlach, Erich R. "AMOCO CADIZ LITIGATION: SUMMARY OF THE 1988 COURT DECISION." International Oil Spill Conference Proceedings 1989, no. 1 (February 1, 1989): 503–8. http://dx.doi.org/10.7901/2169-3358-1989-1-503.
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ABSTRACT In January 1988, Judge Frank McGarr of the United States District Court in Chicago presented the decision concerning all claims by the French government, local communes, fisheries groups, and other parties, concerning the financial liability of the Amoco parties for damages related to the Amoco Cadiz oil spill of March 1978. Several categories of claims, including lost image, lost enjoyment, and ecological damage were eliminated as being uncognizable under French law. Claims for unpaid volunteers who worked on the spill were also eliminated. Most other categories were substantially reduced for a variety of factors including exaggeration, lack of evidence, double billing of certain claims against Amoco Cadiz and the Tanio spill of two years later, and the inability to attribute damage directly to Amoco Cadiz. This paper summarizes the major claims and awards, and discusses the court's decision. Altogether, the court recognized 252.8 million francs of claims against Amoco, plus interest compounded annually at the rate of 7.22 percent since December 31, 1979. Utilizing the current exchange rate (6.28 francs/U.S. dollars) yields an approximate judgment of $40.26 million in claims and $35 million in interest through December 1988. The judgment is expected to be appealed by both sides.
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Gao, Guangyuan, and Shengwang Meng. "STOCHASTIC CLAIMS RESERVING VIA A BAYESIAN SPLINE MODEL WITH RANDOM LOSS RATIO EFFECTS." ASTIN Bulletin 48, no. 1 (July 13, 2017): 55–88. http://dx.doi.org/10.1017/asb.2017.19.
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AbstractWe propose a Bayesian spline model which uses a natural cubicB-spline basis with knots placed at every development period to estimate the unpaid claims. Analogous to the smoothing parameter in a smoothing spline, shrinkage priors are assumed for the coefficients of basis functions. The accident period effect is modeled as a random effect, which facilitate the prediction in a new accident period. For model inference, we use Stan to implement the no-U-turn sampler, an automatically tuned Hamiltonian Monte Carlo. The proposed model is applied to the workers' compensation insurance data in the United States. The lower triangle data is used to validate the model.
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Francia, Peter L. "Free Media and Twitter in the 2016 Presidential Election." Social Science Computer Review 36, no. 4 (September 27, 2017): 440–55. http://dx.doi.org/10.1177/0894439317730302.
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This article examines the surprising outcome of the 2016 presidential election, which saw Donald Trump defy nearly all of the conventional wisdom to become the 45th president of the United States. Political commentators and experts offered several immediate postelection explanations for Trump’s victory, one of which focused on how Trump was able to generate considerable unpaid or free media for himself, often directly through Twitter. This article explains the theory and rationale underlying the free media thesis (FMT) and then examines whether there is any preliminary empirical support for it. Using media tracking data and public opinion surveys, the results reveal that Trump indeed dominated the unpaid media market. Although the findings in this article cannot make causal claims about whether Trump’s advantages in free media are the primary reason for his upset victory, the results, nonetheless, suggest that some of the basic conditions necessary for the FMT were present in the 2016 election and that the FMT offers a plausible avenue for further analysis and future research.
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Park, Geunhye, and Erin Robinson. "The Family and Medical Leave Act: A Policy Analysis and Recommendations to Address Employed Caregiver Burden." Innovation in Aging 4, Supplement_1 (December 1, 2020): 104. http://dx.doi.org/10.1093/geroni/igaa057.344.
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Abstract Family caregiving plays a pivotal role in the long-term care system in the U.S, as there are over 40.4 million people providing unpaid care to individuals aged 65+ (U.S. Bureau of Labor Statistics, 2019). The majority are women providing supports to a parent/grandparent and provide an average of three hours of care each day. This places greater demands on family caregivers in balancing their dual caregiver/employment roles. The Family and Medical Leave Act (FMLA) of 1993 enables family caregivers to take unpaid leave to provide supports to immediate family. While FMLA was intended to provide flexibility to employed caregivers, many struggle with family-work conflicts and caregiver burden is high. Therefore, this conceptual paper offers a critical examination of FMLA and how family caregivers of older adults are impacted. Results of this analysis revealed three themes. First, FMLA is largely inadequate for employed caregivers, as only 60% of the workforce are eligible and unpaid leave restrictions create considerable financial hardship. Second, employer discrimination is high and family caregiving discrimination claims have dramatically increased since FMLA was enacted. And third, many employed caregivers are unaware of FMLA policies and eligibility requirements, which results in underutilization of benefits. Based upon these results, several policy and employer recommendations can be made, such as expanding FMLA coverage to include paid leave and non-immediate family caregivers. Additional recommendations will also be addressed. As it has been nearly 30 years since FMLA was enacted, updated policy is vital to continue supporting employed caregivers in their roles.
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Arena, Amedeo. "From an Unpaid Electricity Bill to the Primacy of EU Law: Gian Galeazzo Stendardi and the Making of Costa v. ENEL." European Journal of International Law 30, no. 3 (August 2019): 1017–37. http://dx.doi.org/10.1093/ejil/chz056.
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Abstract Whilst Costa v. ENEL is the starting point for most accounts of the primacy of EU law, the story of that lawsuit is still relatively unknown. What drove Flaminio Costa to sue his electricity provider over a bill of as little as £1,925 (about €22 in 2019)? Why did the small-claims court of Milan decide to involve both the Italian Constitutional Court and the European Court of Justice in such a ‘petty’ lawsuit? Why did those two courts hand down rulings going in opposite directions? How did the lawsuit end when it came back to the Milan small-claims court? Relying upon previously undisclosed court documents and interviews with some of the actors involved, this article seeks to shed some light on the less-known aspects of the Costa v. ENEL lawsuit, against the background of electricity nationalization in Italy at the height of the Cold War, and to assess the contribution of that lawsuit and of its ‘architect’, Gian Galeazzo Stendardi, to the development of the doctrine of primacy of European Union law.
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GREEN, FRANCIS, JAKE ANDERS, MORAG HENDERSON, and GOLO HENSEKE. "Private Benefits? External Benefits? Outcomes of Private Schooling in 21st Century Britain." Journal of Social Policy 49, no. 4 (October 30, 2019): 724–43. http://dx.doi.org/10.1017/s0047279419000710.
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AbstractPolicy discourse surrounding Britain’s unusually well-resourced private schools surrounds their charitable status and their relationship with low social mobility, but informative evidence is scarce. We present estimates of the extent to which private and external benefits at age 25 are associated with attendance at private school in England in the 21st century. We find a weekly wage premium of 17 percent, and a 12 percentage point lower chance of downward social mobility. By contrast, private schooling is not significantly associated with participation in local voluntary groups, unpaid voluntary work, or charitable giving and fundraising; this finding casts doubt on claims that private schools deliver ‘public benefit’ in this way.
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Chornyi, Vasyl. "Yukos's Principal Shareholders v. Russia." World Trade Review 14, no. 3 (July 2015): 537–39. http://dx.doi.org/10.1017/s1474745615000348.
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Yukos conducted its sales through a network of companies registered in a number of low-tax regions in Russia. Following tax investigation, Russian authorities found it had underpaid taxes and held it liable for unpaid taxes, fines, and penalties of USD 24.18 billion. The tax investigations were accompanied by criminal proceedings against and the subsequent imprisonment of some of Yukos's senior management. Following Yukos's unsuccessful attempts to settle its tax debt, the Russian tax authorities sold its core production facility, YNG, in order to satisfy their tax payment demands. YNG was eventually acquired by the state-owned Rosneft. Yukos then went into bankruptcy, with the Russian State owning 97.67 per cent of the claims against it and receiving 99.71 per cent of the bankruptcy proceeds.
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Lynch, Kathleen, and Mags Crean. "On the question of cheap care: Regarding A History of the World in Seven Cheap Things by Raj Patel and Jason W Moore." Irish Journal of Sociology 27, no. 2 (March 11, 2019): 200–207. http://dx.doi.org/10.1177/0791603519835432.
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One of the most engaging claims of Patel and Moore’s book is that abstract ideas have played a powerful role legitimating the exploitation of swathes of humanity, through distinguishing ontologically and epistemologically between nature and society. As most women, and indigenous people, were defined as part of nature, their labours and lives, including their care labour, were deemed to be part of nature and thereby legitimately exploitable. The authors claim that the cheapening of care arose from the separation of spheres between care work and paid work, between home and the economy, arising from the development of enclosures and the demise of the commons. What the book does not address, however, is how the exploitation of women’s domestic and care labour was not only beneficial to capitalism: men of all classes were and are beneficiaries of women’s unpaid care labour. The authors also suggest that the primary purpose of caring is to reproduce people for capitalism. But caring is not undertaken simply at the behest of capitalism. Nurturing and caring for others are defining features of humanity given the lengthy dependency of humans at birth and at times of vulnerability. The logic of care is very different to market logic.
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Batubara, Marwan, Purnama Ramadani, Rifka Fachrina, Indry Anggraini Putri, and Feri Prayoga. "Analisis Kasus Gagal Bayar Klaim Nasabah Dalam Perusahaan Asuransi Jiwasraya." El-Mal: Jurnal Kajian Ekonomi & Bisnis Islam 3, no. 4 (February 16, 2022): 633–40. http://dx.doi.org/10.47467/elmal.v3i4.989.
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Seeing the 160 years of Jiwasraya's role in the insurance industry does not reflect the condition of SOEs in serious conflicts. Theoretically, all the principles of supervision and reporting, and corporate governance are carried out well by this company. The outstanding performance and achievements of the Jiwasraya Insurance Company have led Jiwasraya to receive several prestigious awards. However, it turns out that this well-known company has a problem that has shocked the masses. This research was conducted using qualitative research methods with a descriptive approach. The researcher chose to use qualitative research methods to determine how to find, collect, process and analyze survey data. In the long term, the JS Saving Plan product poses a risk to the Jiwasraya company, as evidenced by Jiwasraya's $32.89 billion arrears in payments to Jiwasraya's JS Saving Plan product customers. Another thing about Jiwasraya's stock investment in risky companies is the previous losses due to defaults that have not been thoroughly researched and assessed. The role of OJK in settling PT Jiwasraya's unpaid insurance claims. The Financial Services Authority (OJK), as a regulator and supervisor of financial service institutions in Indonesia, is of course obliged to play a role in situations where banking and non-banking financial service institutions in Indonesia are in conflict
Keyword : Strategy, customers, insurance claims.
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Kotouza, Dimitra. "Practices of Labor Activism in Greece: Inside and Outside the Workplace." Journal of Labor and Society 20, no. 3 (December 11, 2017): 379–98. http://dx.doi.org/10.1163/24714607-02003007.
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Confronting mass lay-offs, wage cuts, increasingly precarious conditions, unpaid work, employer violence, and mass unemployment, workers in Greece have organized strikes, workplace occupations, action outside workplaces, and attempts at self-management. These practices, and their strengths and limitations in the context of the crisis, are analyzed using secondary data, ethnographic, and documentary material. Contrasting the tactics located externally to the workplace, such as protests and blockades, to practices of self-management, I argue that the former may better represent the contemporary face of labor activism in Greece. This is because these tactics, despite their limitations, reflect most directly the growing expulsion of workers from a secure wage relation. Attention to the specific obstacles encountered by irregular immigrant workers and women in female-dominated occupations also highlights the important dimension of visibility in tactics external to the workplace. Further, the locus of these tactics in the sphere of circulation allows their connection with broader social claims and communities of struggle.
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B.L.G. "Ohio Court Finds Blue Cross Liable for Misleading Copayment Charges." Journal of Law, Medicine & Ethics 23, no. 4 (1995): 409–10. http://dx.doi.org/10.1017/s1073110500006525.
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On August 29, 1995, the United States District Court for the Northern District of Ohio ruled that certain practices of Blue Cross and Blue Shield of Ohio (BCBSO) relating to the calculation of copayments on insurance claims violated provisions of ERISA, and thus BCBSO could be liable for unpaid benefits and breach of fiduciary duty (McConocha v. Blue Cross & Blue Shield of Ohio, 1995 WL 561444 (N.D. Ohio Aug. 29, 1995)). According to BCBSO's Explanation of Benefits and Schedule of Benefits, beneficiaries were responsible for a 20 percent copayment for hospital charges, and the remaining 80 percent of the Provider's Reasonable Charges would be paid by BCBSO. BCBSO negotiated with the hospitals to create discount agreements whereby the actual charge to BCBSO was less than 80 percent of the total amount of the hospital's charges. By this arrangement, BCBSO paid less than 80 percent of what patients were billed; concurrently, patients paid more than 20 percent of the amount ultimately paid to hospitals for their services.
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Martin, Randy, Kathlynn Tram, Lan Le, and Crystal Simmons. "Financial performance and reimbursement of pharmacist-led chronic care management." American Journal of Health-System Pharmacy 77, no. 23 (September 30, 2020): 1973–79. http://dx.doi.org/10.1093/ajhp/zxaa300.
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Abstract Purpose The purpose of this study was to evaluate the financial performance and reimbursement of chronic care management (CCM) provided by clinical pharmacists in a primary care setting using Current Procedural Terminology codes that were added to the Medicare Physician Fee Schedule in 2017. Methods A retrospective study assessing financial performance of pharmacist-led CCM was conducted for the 12-month period from May 1, 2018, through April 30, 2019, at an academic multiclinic medical practice. Pharmacist-led CCM encounters included a combination of telephone and in-clinic visits. Return on investment, a ratio of net income to financial investment, was the primary outcome. Secondary outcomes included the number of CCM encounters, time spent by pharmacists delivering CCM (ie, “time-on-task”), and third-party claim reimbursement. Result Sixty-five patients were enrolled in CCM during the 12-month study period. Pharmacists provided 236 CCM encounters, including 31 enrollment visits and 102 hours of clinical time-on-task. Gross revenue for CCM during the 12-month period was $7,433.91, and expenses totaled $6,430.36, resulting in a 15.6% return on investment. Out of 158 CCM claims, 131 (83%) were paid and 27 (17%) were unpaid or remained in adjudication at study completion. Conclusion Pharmacist-led CCM resulted in a modest positive return on investment compared to other reimbursable pharmacy services. Practitioners should evaluate opportunities to synergize CCM with other fee-for-service and quality-based reimbursement programs.
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Wynne-Griffith, H. R. "Towards a Pensions Act." Journal of the Staple Inn Actuarial Society 28 (March 1985): 185–87. http://dx.doi.org/10.1017/s0020269x00009816.
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Despite a plea for no more legislation, the author admits to having been overtaken by events. To this extent, the paper should be seen as a review of the current position in 1984. Whilst the trust fund might not be an ideal vehicle it did seem to be the best available and probably better than an alternative, totally new instrument. This view is held by the TUC, Gower, the Wilson Committee, and the Occupational Pensions Board (OPB). The principal deficiency at present is that the three relationships: Employee-Employer, Employer-Trustee and Trustee-Employee need to be better defined. Is membership of a scheme enforceable by an employee under contract law—or, indeed, by the employer? If so, are the benefits enforceable by the employee against the employer if the trustees have inadequate resources? Certain more immediate suggestions were (i) a pension fund should be protected against claims by a liquidator, (ii) the trustees on wind-up should be a creditor ranking with unpaid salaries, (iii) separate bank accounts for trustees and employer (this has now come to pass).
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Casebeer, Adrianne Waldman, Charron Long, Dana Angela Drzayich Jankus, Patrick Racsa, Teresa Rogstad, Bryan A. Loy, and Jonas A. De Souza. "Real-world genetic testing patterns in metastatic colorectal cancer: Balancing adoption challenges with performance efficiency." Journal of Clinical Oncology 36, no. 30_suppl (October 20, 2018): 46. http://dx.doi.org/10.1200/jco.2018.36.30_suppl.46.
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46 Background: Evaluation of real-world data regarding genetic testing for metastatic colorectal cancer (mCRC) highlights the successes and challenges of precision medicine. Guidelines recommend genetic testing to inform mCRC treatment choice. However, there is a lack of real-world evidence regarding genetic testing patterns, including adoption and efficiency. Methods: This retrospective analysis identified adult patients with newly diagnosed mCRC (2015-2106), Medicare Advantage coverage with a pharmacy benefit (MAPD), and claims evidence of CRC-related genetic testing. Inclusion required diagnosis of colon/rectal cancer on ≥2 medical claims and new metastatic disease. Paid and unpaid claims identified genetic testing, which was classified as limited RAS, extended KRAS/NRAS, limited + extended, and BRAF. Efficiency was measured as time-to-testing and time-to-treatment once testing was performed. Results: The study included 4,408 patients with mCRC and MAPD, with a median age of 72 years. Evidence of limited +/- extended testing was noted for 667 (15.1%) of patients. Of these, 78.3% initiated CRC treatment. Limited, extended, and limited + extended testing was observed for 51.7%, 4.5% and 43.8% of patients, respectively. BRAF was observed for 46.4%, 23.3% and 63.7% of patients with limited, extended, or limited + extended testing, respectively. For the 69.2% of patients tested prior to treatment, the median number of days between mCRC diagnosis and first genetic test was 6 [range: 0-31] days, with 25 [13-46] days between testing and treatment. When treatment preceded testing, the median number of days from treatment to test was 72.0 [20-251]. Of patients with > 1 genetic test, most patients had all tests on the same day (96.9%) or within 7 days (97.8%) of diagnosis, with no differences by type of testing. Conclusions: Per guidelines, mCRC-related genetic testing was completed efficiently after diagnosis and prior to treatment initiation for most patients. Genetic testing rates remain low, perhaps indicating barriers to scaling precision medicine. Ongoing research to explore ways to expedite adoption of precision medicine, while maintaining its efficiency, is needed.
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Prout, Alan. "‘Off School Sick’: Mothers' Accounts of School Sickness Absence." Sociological Review 36, no. 4 (November 1988): 765–89. http://dx.doi.org/10.1111/j.1467-954x.1988.tb00707.x.
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Interview material, collected as part of a wider ethnographic study of sickness absence in an English primary school, is used to examine how mothers accounted for their decisions to keep children ‘off school sick’. Mothers' accounts suggested a process by which they tested their children's claims on sickness against suspicions of feigning illness. The paper describes, from the mothers' point of view, the process of negotiating sickness with children and how children are categorised as ‘pretending’, ‘upset’ or ‘really ill’. These decisions are set within a wider context comprising: a normative discourse of maternal child health care; contradictory demands placed on mothers by the image of children as simultaneously robust and vulnerable; the surveillance and contradictory demands of schooling; and the use by children of sickness as a means of exercising influence on their social situation. It is suggested that locating child health care in relation to childrens' point in their childhood career (for these children the transition to secondary school) and acknowledging the active role that children play in the construction of illness will facilitate a fuller picture of mothers' unpaid health work within the family.
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Monedero, Pablo José Abascal. "Family Laws in the European Union." Socialinė teorija, empirija, politika ir praktika 19 (September 16, 2019): 87–94. http://dx.doi.org/10.15388/stepp.2019.13.
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EU social policies should be complemented by contributing to a harmonious development of society, by reducing structural and regional imbalances, developing a balance between the a localized community and the national society, and improving the living standards of citizens and families of member states (Garrido 2002). Such important social policy principles as freedom and justice are addressed and represented in family laws in the EU regulations introduced during the period of 2000–2016. In this article, we studied the EU’s legal solutions in reference to national (Spain) laws on these matters: children and parental responsibility (adoption, child abduction, family benefits) and couples (matrimonial, regimes, prenuptial agreements, provisional measures). This legislation is necessary in the face of the proliferation of families whose members have different nationalities, and even in the mobilization of residences. Cooperation has intensified between national judicial authorities to ensure that legal decisions taken in one EU country are recognized and implemented in any other. This is highly important in civil cases, such as divorce, child custody, maintenance claims, or even bankruptcy and unpaid bills, when the individuals involved live in different countries. The development of family laws is one of the most important factors of family welfare in European countries.
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Ng, Lynn. "Forgotten and Invisible Laborers: Domestic Workers in Singapore and Taiwan." Human Rights in the Global South (HRGS) 1, no. 2 (December 22, 2022): 86–101. http://dx.doi.org/10.56784/hrgs.v1i2.14.
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This paper is about legal yet unjust systems of domestic servitude; the oppressive circumstances that ‘foreign maids’ the world over face as unappreciated, unrecognized, and undervalued workers in the invisible domestic space. Regardless of political culture and regime - liberal democracies to authoritarian governance – ‘maids’ are excluded from normal labor standards. The author explains and discusses the legal blind spots, loopholes, and oversight of labor clauses for foreign domestic workers (FDWs) in the East Asian states of Singapore and Taiwan. This paper aims to spark critical conversations about the public/private divide, also the feasibility of enacting home-based legislation for private household workers. It uses the reviewed literature – relevant research studies, government websites, and news sources – and interview findings to advance its main claims. Between May 2021 and July 2022, the author conducted online semi-structured interviews on WhatsApp/Zoom with 61 people who were directly or indirectly involved in eldercare provision: FDWs, domestic employers, recruitment agency managers, unpaid family caregivers, and NGO workers. The author’s analysis shows that FDWs, called ‘maids’ in the local parlance, face a myriad of shocking abuses by sending/receiving governments, unscrupulous recruitment agencies, and host employers who view them as private property (owned) rather than human beings with needs. This paper argues that FDWs deserve to be respected and included in formal labor laws like the rest of the workforce, to better safeguard their physical safety, mental wellbeing, and personal dignity
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Burgdorf, Julia, John Mulcahy, Halima Amjad, Judith D. Kasper, Kenneth Covinsky, and Jennifer L. Wolff. "Family Caregiver Factors Associated With Emergency Department Utilization Among Community-Living Older Adults With Disabilities." Journal of Primary Care & Community Health 10 (January 2019): 215013271987563. http://dx.doi.org/10.1177/2150132719875636.
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Background: Older adults with disability are frequent users of the emergency department (ED) and often rely on family caregiver support. We identify whether and which caregiver characteristics are associated with older adults’ ED use. Methods: We use Cox proportional hazards regression to model the likelihood of all-cause ED use (defined as 1 or more visits within 12 months of survey) as a function of caregiver characteristics after adjusting for older adult sociodemographic and health characteristics. We draw from linked older adult and caregiver surveys and administrative claims, creating a sample of 2521 community-living older adults with mobility/self-care disability receiving care from a family or unpaid caregiver. Results: About half (52.5%) of older adults receiving mobility or self-care help incurred 1 or more ED visits within 12 months of interview. Adjusting for year of data collection, sociodemographic characteristics, and health status, these older adults were at greater risk of all-cause ED use if their primary caregiver provided greater than 40 hours of care per week (hazard ratio [HR] 1.22, 95% CI 1.04-1.43; P = .02), helped with health care tasks (HR 1.26; 95% CI 1.08-1.46; P < .01), or experienced physical strain (HR 1.18; 95% CI 1.03-1.36; P = .02). Conclusion: Caregiver strain, helping with health care tasks, and greater hours of help per week are associated with heightened risk of ED use among older adults receiving mobility or self-care help. Study findings suggest the potential benefit of caregiver assessment and support.
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Haslam McKenzie, Fiona. "The Challenges of Achieving Community Self-determination and Capacity Building in a Neo-liberal Political Environment." Australian Journal of Primary Health 9, no. 1 (2003): 39. http://dx.doi.org/10.1071/py03005.
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In Australia over the last 30 years, there has been a shift in federal and state government regional development policies and their engagement with regional communities and regional development. Previously, regional development tended to be a paternalistic and highly centralized, whereas current development policy emphasises entrepreneurialism and self-determination. It is evident from research that, while government policies have used the rhetoric of community self-determination, capacity building and regionalism, de-regulation has undermined the funding necessary to make good the claims. Insistence on self-reliance and the cutting of funding in the name of community autonomy deplete community resources and the pillars of social capital. At the same time, the capacity to work co-operatively, to collaborate, and build trust and networks in order to maintain social cohesion and social capital, undermines the principles of neo-liberalism. Neo-liberalism fails to value unpaid work, community bonds, local knowledge and leadership, and there is limited real acknowledgment by government of their value, nor concern for the future of smaller communities which are undermined by neo-liberalism. This paper examines the associated ambiguities of attaining economic efficiency in a global, neo-liberal economic environment, while at the same time sustaining the social capital of non-metropolitan regional communities and the physical environment in the Central Wheatbelt of Western Australia. It reviews case studies where the notion of capacity building has had meaningful outcomes for rural communities and compares them to other examples where the reality has not matched the rhetoric.
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Chambers, Georgina M., Stella Nalukwago Settumba, Kate A. Carey, Anita Cairns, Manoj P. Menezes, Monique Ryan, and Michelle A. Farrar. "Prenusinersen economic and health-related quality of life burden of spinal muscular atrophy." Neurology 95, no. 1 (June 8, 2020): e1-e10. http://dx.doi.org/10.1212/wnl.0000000000009715.
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ObjectiveTo quantify the economic and health-related quality of life (HRQoL) burden incurred by households with a child affected by spinal muscular atrophy (SMA).MethodsHospital records, insurance claims, and detailed resource use questionnaires completed by caregivers were used to capture the direct and indirect costs to households of 40 children affected by SMA I, II, and III in Australia between 2016 and 2017. Prevalence costing methods were used and reported in 2017 US dollar (USD) purchasing power parity (PPP). The HRQoL for patients and primary caregivers was quantified with the youth version of the EQ-5D and CareQoL multiattribute utility instruments and Australian utility weights.ResultsThe average total annual cost of SMA per household was $143,705 USD PPP for all SMA types (SMA I $229,346, SMA II $150,909, SMA III $94,948). Direct costs accounted for 56% of total costs. The average total indirect health care costs for all SMA types were $63,145 per annum and were highest in families affected by SMA II. Loss of income and unpaid informal care made up 24.2% and 19.8% respectively, of annual SMA costs. Three of 4 (78%) caregivers stated that they experienced financial problems because of care tasks. The loss in HRQoL of children affected by SMA and caregivers was substantial, with average caregiver and patient scores of 0.708 and 0.115, respectively (reference range 0 = death and 1 = full health).ConclusionOur results demonstrate the substantial and far-ranging economic and quality of life burden on households and society of SMA and are essential to fully understanding the health benefits and cost-effectiveness associated with emerging disease-modifying therapies for SMA.
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Whitney, Shiloh. "Byproductive labor." Philosophy & Social Criticism 44, no. 6 (December 14, 2017): 637–60. http://dx.doi.org/10.1177/0191453717741934.
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My aim in this paper is to introduce a theory of affective labor as byproductive, a concept I develop through analysis of the phenomenology of various affective labor practices in dialog with feminist scholarship, both on gendered and racialized labor, and on affect and emotion. I motivate my theory in the context of literature on affective and emotional labor in philosophy and the social sciences, engaging the post-Marxist literature on affective and immaterial labor and emphasizing feminist critiques. I argue that affective labor is not only the work of producing affects for others to consume or the reproductive work that rejuvenates and sustains labor power and social life, but also the work of metabolizing waste affects and affective byproducts. Thus, byproductive labor is a neologism I develop to bring into view an affective economy and indeed a political economy of affects to the side of the distinction between productive and reproductive labor in its paid and unpaid variants. I make three central claims: (1) affective labor invariably creates byproducts in the embodied subjectivity of the worker; (2) the unique kind of affective expenditure I call “byproductive” (metabolizing affective surplus, containing affective waste, and producing depleted affective agency) is a defining feature of affective labor not circumscribed by the productive–reproductive distinction; and (3) the marginalized forms of subjectivity and depleted agency constituted through the intersections of this labor with hierarchies of gender, race, and migrant status or global class are themselves byproducts of affective labor. Thus, theorizing affective labor as byproductive captures the uniqueness of affective labor and the forms of exploitation unique to it, but also explains the interaction of affective labor with forms of power that operate through subjection and marginalization.
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Busby, Nicole. "The evolution of gender equality and related employment policies." International Journal of Discrimination and the Law 18, no. 2-3 (June 2018): 104–23. http://dx.doi.org/10.1177/1358229118788458.
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European Union (EU) law and policy on work–family reconciliation has developed by way of two parallel but often incoherent movements. The jurisprudence of the Court of Justice of the EU has been a driving force in its interpretation of sex discrimination provisions in the context of claims concerning women’s labour market experiences, which have subsequently been codified, for example, to provide positive rights in relation to pregnancy and maternity. Alongside this development, policy has been linked to wider economic concerns such as the goal of full employment leading to specific measures intended to equalize employment conditions for those with non-standard working arrangements and to encourage shared parenting between men and women. The lack of a specific focus on work–family reconciliation as a goal for law and policy in its own right has resulted in a patchwork of provisions rather than an overarching framework. The net result is that EU law provides an unsatisfactory response to what has been termed the unsolved conflict between paid work and unpaid care. Recent developments may provide a solution. The Commission has reinvigorated its interest through its ‘New Start’ initiative – a package of both legislative and non-legislative measures under the auspices of the European Pillar of Social Rights launched in April 2017. Provisions incorporate, inter alia, a proposed directive that would amend the parental leave regime and introduce paid paternity and carers’ leave. This article provides a critique of law and policy to date and assesses the potential for a coordinated EU strategy for work–family reconciliation, focusing specifically on gender equality. It is argued that, even with the enhanced interest of the Commission, it may be difficult to achieve a coordinated approach to what has always been a contentious policy area within a rapidly changing EU although the United Kingdom’s departure from the EU may provide an opportunity in this respect.
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Kim, Hee Ju. "A Study on the Rational Solution of Immediate Annuity Issues through the Precedent Analysis." Korean Insurance Law Association 16, no. 3 (October 31, 2022): 217–71. http://dx.doi.org/10.36248/kdps.2022.16.3.217.
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In the disputes over immediate annuity insurance, the court's judgments of the first and second instances related to the insurer's duty to explain are presented. The disputes began in 2017, and the Financial Supervisory Service's Dispute Mediation Committee recommended that all inherited annuity products(maturity refund type) subscribers pay additional underpaid insurance, but insurers refused to pay collectively except for the mediation case. According to the precedents that consumers have won so far, insurers should specify the risks that “insurers can pay less than the minimum guaranteed rate at the time of the fall in interest rates” and “the monthly pension amount shall be paid after deducting the reserves for financing the maturity refund” in the terms and conditions. In addition, on the basis that the insurance company did not explain this to the customer, the court applied Article 3, Paragraph 4 of Act on the Regulation of Terms and Conditions to invalidate the incorporation into the contents of the insurance contract. Furthermore, the court orders the insurance company to pay the difference to the consumer based on the difference from the minimum guaranteed interest rate or the initial annuity insurance money (the amount without deducting the accumulated amount for the maturity refund fund). In this study, it was considered reasonable to apply Article 102 of the Old Insurance Business Act (current Articles 44 and 45 of Act on the Protection of Financial Consumers) rather than applying Article 3, Paragraph 4 of Act on the Regulation of Terms and Conditions when the insurer violates the duty of explanation. Also, the policyholder's negligence offset can be applied individually, and fairness can be established in accounting for unpaid insurance money. Moreover, in the immediate annuity insurance case, policyholders recognized that the insurer had violated the duty of explanation only after the monthly annuity less than the minimum guaranteed interest rate was paid. The question is whether to view it as the payment date of the monthly annuity of the company or as the time when the existence of the right to claim insurance money was known. In the judgments related to immediate annuity that have been issued so far, the position is that an insurer who refuses to pay insurance loses the lawsuit and that it is unacceptable as an abuse of rights against the principle of good faith that the statute of limitations for claiming insurance has expired. The Supreme Court precedent regarding accidental death benefit considered more emphasis on the pursuit of legal stability, refusing to recognize restrictions based on the principle of good faith, and strictly interpreting the extinctive prescription period. Presumably, the short-term limitation of three years (2 years in most cases subject to immediate annuity) applies to the right to claim insurance money, and it is difficult for general consumers to understand that they must file a claim in court to stop the extinctive prescription period. When the insurer refuses to pay the insurance money, the consumer believes the insurer's words and in most cases gives up on the claim, and even after a court judgment has been issued and the insurance claim is subject to the extinctive prescription period, the claim is frustrated again. Seems to be a very unreasonable result for consumers in. It is necessary to avoid the attitude of omitting key points and not explaining them in detail by delegating specific details to complex and difficult product terms and conditions. I think it's time to listen to the alternative of applying subjective starting points to insurance claims subject to short-term limitation period.
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Невінгловська, Ю. М. "JUDICIAL PROTECTION OF ECONOMIC COMPETITION AND RESTRICTIONS OF MONOPOLISM IN UKRAINE." Juridical science 2, no. 4(106) (April 3, 2020): 130–35. http://dx.doi.org/10.32844/2222-5374-2020-106-4-2.16.
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The article examines the judicial protection of economic competition and the restriction of monopoly in Ukraine. On the way to Ukraine’s transition to new economic institutions, there is a need to create new relationships between different business entities. International standards require the introduction and continuous improvement of the mechanism of judicial protection of economic competition and the restriction of monopoly in Ukraine, which is the basis of the protection mechanism and ensure the restoration of violated rights of both entrepreneurs and consumers. Today in Ukraine, the lack of real planning in the economic sphere leads to the absence of such production, unemployment and other negative processes in the economic sphere. It is determined that business entities have the right to appeal to the court against the decision of any public authority or local government body to apply administrative and economic sanctions to it. If a state authority or local self-government body adopts an act that does not comply with the law and violates the rights or legitimate interests of the business entity, the latter has the right to apply to the court to declare such an act invalid. It was found out that the court enforces the decisions of the Antimonopoly Committee of Ukraine, such as the application of fines and penalties accrued on the unpaid amount of the fine. In addition, the law stipulates that the state commissioner of the Antimonopoly Committee of Ukraine, the head of the territorial branch of the Antimonopoly Committee of Ukraine or their authorized employees of the Antimonopoly Committee of Ukraine, its territorial branches have the right to get acquainted with these cases and receive copies. The Antimonopoly Committee of Ukraine and its territorial branches have the right to intervene as third parties who do not make independent claims on the subject of the dispute, if the decision may affect their rights and responsibilities in exercising state control over the protection of economic competition. Judicial protection of economic competition and restriction of monopoly in Ukraine is a highly specialized area based on a set of administrative, economic, commercial, civil and commercial law to restore the violated right, protection and defense of violated rights of both entrepreneurs and consumers.
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Stankevič, Adam. "MERKINĖS SENIŪNO MATO OGINSKIO KASDIENYBĖ: ŪKINIŲ IR TEISMINIŲ REIKALŲ VERPETUOSE." Lietuvos Didžioji Kunigaikštystė Visuomenė. Kasdienybės istorija, T. 4 (October 8, 2018): 98–115. http://dx.doi.org/10.33918/xviiiastudijos/t.4/a4.
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The article analyses some episodes from biography and the daily life of elder of Merkinė, vogt and colonel of a petyhorcy unit of the armed forces of the Grand Duchy of Lithuania Mateusz Ogiński (1738–1786). On the basis of the documents preserved in the Ogiński foundation of the Lithuanian State history archive (F. 1177), the article argues that Mateusz Ogiński was mainly occupied with the maintenance of his properties and litigation in courts, not actually seeking any political or public career. He personally issued directions to the stewards of his properties and controlled execution of his orders. Somewhere close to the First Partition of the Polish-Lithuanian Commonwealth (1772) he was known for the detailed regulation of his economic activities. He put effort to concentrate in his hands some real estate (by buying plots and houses in Merkinė), invested and developed various businesses (renting a windmill and a pub, operating a coffee shop, building a sawmill and a brickyard, fishing, shipping timber to Konigsberg, renovating Merkinė’s town hall, etc.). Later M. Ogiński was often renting out his properties to other individuals, but that had a negative influence on his possessions. Lifestyle that disregarded the income made M. Ogiński drown in debt early, and he entered a loop of having to start borrowing to pay debts. Elder of Merkinė Ogiński would borrow and spend large sums of money to make purchases of various items of luxury abroad and in Lithuania (clothes, jewellery, alcohol, species, fruits, etc.), and to maintain his manor and even a folk music group. M. Ogiński litigated in many Lithuanian courts and, judging from his letters (and quite many of them survived), he would have inhabited these litigation processes, taking interest in legal nuances and using different opportunities to influence court processes to his advantage (making acquaintance with judges, looking for third party interceders, writing letters to judges, and personally participating in court proceedings). Most common lawsuits against him were about unpaid debts, yet his own claims were against stewards of his properties, and real estate rights. Keywords: eldership of Merkinė, the Ogiński, daily routine, economics, courts.
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Moyar, Dean. "Unstable Autonomy: Conscience and Judgment in Kant's Moral Philosophy." Journal of Moral Philosophy 5, no. 3 (2008): 327–60. http://dx.doi.org/10.1163/174552408x369709.
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AbstractIn this paper I argue that Kant's claims about conscience in his moral writings of the 1790s reveal a fundamental instability in his moral philosophy. The central issue is the relationship between the moral law as the form of universality and the judgment of individuals about specific cases. Against Thomas Hill's claim that Kant has only a limited role for conscience, I argue that conscience has a comprehensive role in Kantian deliberation. I unpack the claims about conscience in the Metaphysics of Morals to show that they describe conscience as both a basic act of self-consciousness and as an all-things-considered judgment. I outline the role of conscience in moral motivation, and argue that taken together Kant's writings about conscience reveal a way to rethink Kant's conception of the Fact of Reason.
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Beach, Derek, and Jonas Gejl Kaas. "The Great Divides: Incommensurability, the Impossibility of Mixed-Methodology, and What to Do about It." International Studies Review 22, no. 2 (March 24, 2020): 214–35. http://dx.doi.org/10.1093/isr/viaa016.
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Abstract There is still significant confusion about how multimethod research can be undertaken and even if it is possible. The article makes the claims that much of the confusion is the result of a failure to distinguish between multimethod and multimethodology research. We argue that there are at least three different methodological languages: variance-based, case-based, and interpretivist. The article starts by discussing the ontological and epistemological foundations underlying the three different methodologies that result in them making very different types of claims evidenced with very different empirical material. Variance-based methodologies assesses mean causal effects across a set of cases, whereas case-based methodologies focus on how a causal process works within a case. Markedly different from the causally oriented variance- and case-bases approaches, interpretivist research ask questions about human meaning-making in specific contexts. While the claim of methodological incommensurability is not a new claim, the contribution we make in this article is to unpack more clearly the irreconcilable differences that exist across the three methodologies and how they play out in international studies scholarship, and to provide suggestions for what we can do about it.
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Rousseau-Houle, Thérèse. "Le dol d'un locateur peut·il être sanctionné par une diminution du loyer?" Chronique de jurisprudence 18, no. 2-3 (April 12, 2005): 577–83. http://dx.doi.org/10.7202/042177ar.
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A lessee requests a reduction of his rent in reply to a claim for unpaid rents. His request is based upon the lessor's false representations as to the business a building was liable to bring to lessee's restaurant situated therein. The principal claim was sustained and the cross-claim rejected. The only recourse open in case of fraudulent manoeuvres would have been an action in nullity.
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Patenaude, Micheline. "L'origine de la primauté du privilège d'une banque sur les droits d'un vendeur impayé." Les Cahiers de droit 22, no. 3-4 (April 12, 2005): 667–80. http://dx.doi.org/10.7202/042462ar.
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In this article, the author studies the reasons that led the legislator to amend, in 1861, a law adopted in 1859 in order to specify that the claim of the holder of a bill of lading or of a warehouse receitpt has priority over the claim of any unpaid vendor. The study is particularly relevant due to the fact that section 179 of the actual Bank Act is directly derivated from the 1861 amendment without any significant modification. The study of the rights held by the pledger and the unpaid vendor at the time when the legislator adopted the above mentioned amendmend leads the author to conclusions as to the reasons that made this amendment necessary, as well as to the significance of section 179 in the Bank Act.
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Opara, Stanley Chibuzo, Pauline Stanton, and Waheduzzaman Wahed. "For love or money: human resource management in the performing arts." Employee Relations: The International Journal 41, no. 6 (September 16, 2019): 1451–66. http://dx.doi.org/10.1108/er-05-2018-0128.
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Purpose The purpose of this paper is to focus on the perceptions of key stakeholders of the human resource management (HRM) practices and challenges in performing arts organisations in Victoria, Australia. Challenges include the precarious nature of employment in the industry; poor wages and conditions leading to financial insecurity and the domination of the industry by small- and medium-sized organisations. The passion and commitment of the performing arts workforce are both a strength and a weakness in that they “buy in” to the expectations of long hours and unpaid work. These challenges impact on managers and administrators as well as performers and raise many challenges for the HRM function and places constraints on even basic HRM practices. Despite the claims of the stakeholders that the large companies have sophisticated HRM practices the early evidence suggests otherwise. Furthermore, many of these problems cannot be solved at the organisational level and need an industry and government response. Design/methodology/approach A qualitative research approach is used to guide this study as it allows contextual evaluation of the data. Eight key stakeholders interviewed for this study included one official specialising in industrial relations from Live Performance Australia, one official from the Media and Entertainment and Arts Alliance, two government officials from the State government, one with responsibility for working with Performing Arts companies in relation to funding and resources, and the other with responsibility for government arts policy development; two chief executive officers – one from a small arts company and the other from a large arts company; one HR director from a large arts company; and one manager from a small-to-medium-size company. Face-to-face, semi-structured interviews were undertaken to provide an information-rich inquiry. Findings The study suggests that there are considerable barriers to the effective adoption and implementation of HRM in the performing arts. In particular, the research identified four major features that impact on HRM practices in the arts sector. These are: first, the precarious nature of employment, due to the short-term and project focussed work. Second, the reliance on often limited government funding, supplemented by philanthropy, sponsorship and box office takings, leading to short-term and long-term financial insecurity and limited capacity for long-term planning. Third, limited resources and high levels of casualisation which leads to low income, poor working conditions, lack of training and few opportunities for career development. Fourth, despite these difficult conditions, the sector appears to attract a highly motivated and committed workforce including not just performers but also managers and administrators and the sector appears to rely on their passion, commitment and shared endeavour. Research limitations/implications The study has limitations. For example, it focussed at the macro level of key stakeholders rather than at the organisational level which is the usual unit of analysis for HRM studies. The stakeholders made many claims about HRM practices that need to be explored in further research at the organisational level. Also, apart from the trade union interviewee, the employee voice is missing. Again, further research into both performing arts practitioners and managers and administrators would be valuable future research. Practical implications This study raises a number of implications for practice. The first is that government policy makers need to focus on the sustainability of their funding models and take account of the myriad of evidence that now exists in regard to the detrimental impact of precarious employment in the increasingly valuable performing arts sector. A policy approach that highlights longevity and development of the sector rather than an emphasis on encouraging competition between small companies for financial survival has much to offer. The second is in relation to industry players who rather than blaming governments could take some control through supporting the growth of networks that could provide training and development and career development opportunities for organisations and individuals (Hennekam and Bennett, 2017). Originality/value This study contributes to the understanding of HRM systems and practices in the performing arts.
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Yeong-Don Loh. "The Reimbursement Claim for the Postal Savings of Sakhalin Koreans Unpaid by Japan during the World War II." SungKyunKwan Law Review 29, no. 2 (June 2017): 43–67. http://dx.doi.org/10.17008/skklr.2017.29.2.002.
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Dhaked, Narendra Singh, Mukesh B. Nariya, and Acharya R. N. "Pharmacological evaluation of Vrishya karma (Aphrodisiac activity) of Whole plant of Lavandula bipinnata (Roth) Kuntze." International Journal of Ayurvedic Medicine 12, no. 3 (September 29, 2021): 529–33. http://dx.doi.org/10.47552/ijam.v12i3.2130.
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Background: Lavandula bipinnata Roth. of family Lamiaceae known as Kamaraja in Odisha is an erect, strongly fragrant, annual herb with multifaceted ethno medicinal claims to treat, poisons, tooth ache, anxiety, depression, headache, cold and sexual disorder etc. Aim: To study the effect of whole plant of Lavandula bipinnata for its aphrodisiac activity in albino rats. Material Methods: The sexually active male rats were chosen separately and divided into 2 groups; each group consisting of 6 animals and the study was carried by using the suitable animal experimental model. The data generated during the study were analyzed by employing Student’s‘t’ test for paired and unpaired data as applicable to determine significant difference between groups at P<0.05. Results: Lavandula bipinnata showed significant increase in weight of rats in comparison with initial weight. Test drug provided significant increase in mounting frequency, licking, chasing, genital sniffing, in comparison to control group and non-significant increase in mounting latency and serum testosterone level. Conclusion: Lavandula bipinnata whole plant possess significant aphrodisiac activity in test rat model and confirms its traditional claim as an aphrodisiac.
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Russell, Roseanne. "Women and the ‘Business’ of Human Rights: The Problem with Women’s Empowerment Projects and the Need for Corporate Reform." Business and Human Rights Journal 7, no. 1 (February 2022): 84–99. http://dx.doi.org/10.1017/bhj.2021.50.
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AbstractCorporate-led women’s empowerment initiatives appear, in their proactiveness, to be a welcome addition to a range of measures addressing adverse human rights impacts by business. This article questions the claim that these projects significantly advance women’s rights. Instead, they can be understood as a manifestation of what Catherine Rottenberg terms ‘neoliberal feminism’ with women at risk of being transformed into ‘gender capital’ for business gain. This article rejects the claim that empowerment can only be delivered by encouraging women into market-based work. Instead, it is argued that the corporate responsibility to respect the human rights of women can better be supported by reorienting business away from its preoccupation with delivering value for shareholders, towards an approach that values women’s unpaid socially reproductive labour.
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Kilian, Cornelius G., and Elizabeth Snyman-Van Deventer. "Claiming Damages where Dividends remain Unpaid: A Contribution towards a More Balanced Approach in South Africa." Potchefstroom Electronic Law Journal 20 (November 2, 2017): 1–26. http://dx.doi.org/10.17159/1727-3781/2017/v20i0a1322.
Full textAbstract:
In the matter between Sumiseki Materials Co Ltd v Wambo Coal Pty Ltd 2013 NSWSC 235 (25 Mar 2013) the Supreme Court of New South Wales had to decide on the legal difficulty arising from unpaid dividends. The Court was required to decide whether a shareholder has a right to a predetermined annual dividend. The principles applied by the Supreme Court entailed estoppel (common law), minority oppression (company law) and contractual law principles. Although the principles of estoppel were relevant, these fall outside the ambit of this article concerning unpaid dividends. The Supreme Court cited approximately 40 cases and considered 5000 pages of documentary evidence pertaining to the contractual right to a predetermined dividend. Although the latter seems applicable and relevant to the South African corporate law environment, South African case law does not support it. Besides a contractual right, this article also investigates the Oxford Legal Group case in establishing at least an implied right (based on the doctrine of proper purpose) to claim an undeclared dividend or unauthorised dividend that is contrary to the board of directors discretion not to authorise any dividends. Both these cases argue when and why a court should interfere in company resolutions in striking a better balance between a right to a dividend and a company's discretionary power not to recommend or declare a dividend.
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Kilian, Cornelius G., and Elizabeth Snyman-Van Deventer. "Claiming Damages where Dividends remain Unpaid: A Contribution towards a More Balanced Approach in South Africa." Potchefstroom Electronic Law Journal / Potchefstroomse Elektroniese Regsblad 20 (November 2, 2017): 1–26. http://dx.doi.org/10.17159/1727-3781/2017/v20i0a4175.
Full textAbstract:
In the matter between Sumiseki Materials Co Ltd v Wambo Coal Pty Ltd 2013 NSWSC 235 (25 Mar 2013) the Supreme Court of New South Wales had to decide on the legal difficulty arising from unpaid dividends. The Court was required to decide whether a shareholder has a right to a predetermined annual dividend. The principles applied by the Supreme Court entailed estoppel (common law), minority oppression (company law) and contractual law principles. Although the principles of estoppel were relevant, these fall outside the ambit of this article concerning unpaid dividends. The Supreme Court cited approximately 40 cases and considered 5000 pages of documentary evidence pertaining to the contractual right to a predetermined dividend. Although the latter seems applicable and relevant to the South African corporate law environment, South African case law does not support it. Besides a contractual right, this article also investigates the Oxford Legal Group case in establishing at least an implied right (based on the doctrine of proper purpose) to claim an undeclared dividend or unauthorised dividend that is contrary to the board of directors discretion not to authorise any dividends. Both these cases argue when and why a court should interfere in company resolutions in striking a better balance between a right to a dividend and a company's discretionary power not to recommend or declare a dividend.
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Kuyper, Jonathan, and Benjamin Moffitt. "Transnational Populism, Democracy, and Representation: Pitfalls and Potentialities." Global Justice : Theory Practice Rhetoric 12, no. 02 (November 15, 2020): 27–49. http://dx.doi.org/10.21248/gjn.12.02.208.
Full textAbstract:
Current work on populism stresses its relationship to nationalism. However, populists increasingly make claims to represent ‘the people’ across beyond national borders. This advent of ‘transnational populism’ has implications for work on cosmopolitan democracy and global justice. In this paper, we advance and substantiate three claims. First, we stress populism’s performative and claimmaking nature. Second, we argue that transnational populism is both theoretically possible and empirically evident in the contemporary global political landscape. Finally, we link these points to debates on democracy beyond the state. We argue that, due to the a) performative nature of populism, b) complex interdependencies of peoples, and c) need for populists to gain and maintain support, individuals in one state will potentially have their preferences, interests, and wants altered by transnational populists’ representative claims. We unpack what is normatively problematic in terms of democratic legitimacy about this and discuss institutional and non-institutional remedies.