1. Il-Joon Jo / Manager Compensation Department Suwon Branch Office

2. Introduction Customizing ServicesMain Accomplishment Medical Care Benefits

3. Introduction 1. Why? Customizing services 2. Customizing Service of Samsung Life Insurance 3. New Mission & Vision 4. CEO Management Polices

5. All-Touch Activities CS HQ. Holograph DM Call Ctr. OB Call FC Holograph DM ThanksgivingExecutive Branch TA Asst. ContractorGuide FamilyBookletField Visit Support EventSMS Customer Touch ratio & CSI Improvement

6. Mission Vision Key Values

7. Management Policies Creating a higher value of existence Organization opened for sharing and communication Serving attitudes & their practices

8. Medical Care Benefits 1. Overview 2. Process and Scope 3. Work-related Accident

9. Work-related Accident WCI Medical Institution Medical Care Benefits Recovery from Injury Disability Benefits COMWELCOMWEL Vocational Rehabilitation Non-WCI Medical Institution Return to work Claim for Medical Care Expenses Transfer following a first-aid treatment If an injured worker can’t receive medical treatment from an authorized Institution, ….

10. Injured Worker COMWEL employer Medical Institution

11. There happens a work-related accident Transfer to a medical institution

12. Is the medical institution designated by COMWEL? Non designated? Transfer to WCI institution

13. Make an application for medical care benefits (WCI medical institutions can act on behalf of workers.) Specify the details(including his/her workplace, the Background of the accident, and medical opinions)!

14. Sign on the application. Submit it to the medical institution. (To get a medical opinion)

15. Submit a copy of it to our branch office A notice of determination within 7 days

16. It may take longer… (for concrete verification) If denied, He/she has a right to appeal for a review

17. Examination & Test Hospitalization Treatment & Operation Medications Nursing and Patient caring Transfers

18.  a significant causal relationship  but the injuries caused by his/her willfulness or criminal acts are not covered arise out of and in the course of employment

19. Act of performing His/her duties Physiologically necessary deeds Act of preparing for work Acts expected As a social norm Such as acts of emergency refuge

20. If caused in violation of specific instructions from the employer Not covered due to defect in, or the careless mgmt. by the employment

21. While using a means of Transport provided by the employer or can be regarded as being provided by the employer Not have entire and exclusive Responsibility to manage or use the means of transport

22. VIolating regulations, self injury, criminal offenses Not covered Due to an act that can be seen under the control of the employer

23. Private action, self injury, violation of instructions Not covered outside working place

24. Where the employer orders the worker to participate in the event Other cases where the employer has usually and customarily recognized the worker’s participation in the event After obtaining Approval from the Employer in advance When the employer recognizes his/her hours to participate in the event as hours worked

25. Exposed to hazardous materials to require a medical care When occurs as a result of a work-related injury a specific clinical symptoms

26. The causal relationship Between the injury and diseases should be medically recognized Taking into account the worker’s sex, age, health, physical constitutions, etc. Not caused by a naturally happening syndrome

27. Customizing Services 1. Customers 2. Flow Chart 5. Integrated VOC System 3. Operating System 4. Customer-Serving Mgt. System

28. “13 millions” “1.95 millions” Workers’ Compensation Employment Insurance Supports for Becoming a Member & Paying Premiums “80 thousand” Unemployed Workers Business Launching & Financial Supports “7.3 millions” Low Income Workers Credit Guarantee & Financial Supports Workers’ Compensation Compensation, Care, Rehabilitation

30. Business Policy Execution & Maintenance Business Goal Internal Inspection Management Review Quality Management Manual /Laws and Enforcement Decrees Procedure Document Guideline Document Regulation Detailed Regulation Occurrence of non-confirmity Investigation of the Cause Correction Action Correction Action

32. ·Classification by the Cause ·Improvement Activities ·VOC BP Pick up ·Improvement in Service

45. 1. Findings on CSI Survey 2. Period for Return to Society Main Accomplishment 3. Innovation in Medical Care

46. 82.1 2008 84.2 2009 2005200620072008 71.0 73.6 78.4 79.7 2009 83.3

47. 산재근로자 사회복귀 소요비용 절감

48. 산재요양·보상서비스 혁신

49. Il-Joon Jo Tel : 82-31-231-4424 E-mail: brightjo@kcomwel.or.krbrightjo@kcomwel.or.kr