Suchergebnisse

This paper deals with clauses agreed upon, inserted in the insurance contract including some risks from the scope of insured risks. The paper deals with Validity of such clauses and the protection of insured person considered as weaker party in the contract of insurance.The paper highlights the position of Jordanian courts, it pays particular intention to comparative doctrines and legislation.

В статье исследуются проблемы осуществления страхования здоровья в России. Автор выделяет основные особенности российского страхования здоровья. В работе обозначены некоторые наиболее существенные проблемы осуществления страхования здоровья и обозначены основные пути преодоления данных пробелов действующего российского законодательства. ; The article investigates the problem of the health insurance in Russia. The author identifies the basic features of the Russian health insurance. The paper highlights some of the most significant problems of the health insurance and outlines the key ways to overcome these gaps existing Russian legislation.

The concept of 'working time' for a period of stand-by time according to a stand-by system applicable to firefighters was interpreted by the Court in MG (C-214/20). In the Y case (C-636/19), the Court interpreted the concept of 'insured person' for the purpose of reimbursement of healthcare costs under Directive 2011/24. In the TS case (C-538/19), the Court dealt with another cross-border healthcare case. This time the question was whether a Member State can require an authorisation for cross-border healthcare to be subject to the submission of a medical report drawn up by a doctor from its national public health insurance system in light of Article 20 of Regulation 883/2004 and Article 56 TFEU. In ASGI and APN (C-462/20), the exclusion of third-country nationals from the eligibility to the Italian family card was under scrutiny. In SC (C-866/19), the Court clarified that the principle of aggregation applies to the calculation of the theoretical amount of benefit but not to the calculation of the actual amount of benefit under Article 52(1)(b) of Regulation 883/2004. In K (C-285/20), the Court held that being on sick leave and receiving sickness benefits can be considered as equivalent to the pursuit of an economic activity for the purpose of applying the rules on unemployment benefits for wholly unemployed frontier workers under Article 65(2) and (5) of Regulation 883/2004.

"The European Union is currently experiencing a kind of 'renaissance of selfemployment'. As part of this trend, the share of self-employed workers who are operating their enterprises without the support of dependent employees is growing particularly evidently. Members of this category of self-employed are known as 'ownaccount workers'. Proceeding from the theory of transitional labour markets, the authors develop a concept with which mobility rates and mobility patterns can be used to compare the dynamics of own-account work (entries, exits and duration) in five different European countries (Germany, the Netherlands, Italy, United Kingdom and occasionally Sweden). Against this background, the insurance coverage offered to the self-employed as well as that enjoyed by persons entering or exiting the status of selfemployment are then observed and compared across the different countries." (author's abstract)

The European Union is currently experiencing a kind of 'renaissance of selfemployment'. As part of this trend, the share of self-employed workers who are operating their enterprises without the support of dependent employees is growing particularly evidently. Members of this category of self-employed are known as 'ownaccount workers'. Proceeding from the theory of transitional labour markets, the authors develop a concept with which mobility rates and mobility patterns can be used to compare the dynamics of own-account work (entries, exits and duration) in five different European countries (Germany, the Netherlands, Italy, United Kingdom and occasionally Sweden). Against this background, the insurance coverage offered to the self-employed as well as that enjoyed by persons entering or exiting the status of selfemployment are then observed and compared across the different countries. ; Die selbstständige Erwerbsarbeit hat in den letzten Jahrzehnten in der Mehrzahl der EUMitgliedsstaaten an Bedeutung gewonnen. Insbesondere der Anteil von Klein- und Solo-Unternehmen weist eine steigende Tendenz auf. Im Kontext der Theorie der Übergangsarbeitsmärkte wird ein Mobilitätskonzept entwickelt und die Dynamik der Solo-Selbstständigkeit anhand von Mobilitätsraten und Mobilitätsmustern (Eintritte, Austritte, Dauer) in fünf europäischen Ländern (Deutschland, den Niederlanden, Italien, Großbritannien und Schweden) verglichen. Abschließend wird auf die national unterschiedliche institutionelle Absicherung von Mobilität bzw. von Übergängen eingegangen. Am Beispiel der staatlichen Rentenversicherungssysteme wird aufgezeigt, ob Statuswechsel in und aus der Solo- Selbstständigkeit heraus in sozialversicherungsrechtlicher Hinsicht in den betrachteten Ländern mit Nachteilen verbunden sind.

В статье подробно рассматриваются случаи, при которых застрахованное лицо имеет право на получение пособия по временной нетрудоспособности в соответствии с Федеральным законом РФ от 29 декабря 2006 г. № 255-ФЗ «Об обязательном социальном страховании на случай временной нетрудоспособности и в связи с материнством». Также в ней определяется, в зависимости от заболевания и условий трудового договора, временной период, в течение которого застрахованному лицу выплачивается пособие по временной нетрудоспособности. Отдельно оговариваются ситуации, когда застрахованное лицо признано инвалидом либо контактировавшим с инфекционным больным или с лицом, у которого выявлено бактерионосительство, или осуществляет уход за больным членом семьи. Кроме того, раскрывается методика расчета пособия по временной нетрудоспособности и приводится пример ее расчета. ; The article thouroughly considers the cases in which an insured person has a right on temporary disability benefits under the legislation of the Russian Federation on December 29, 2006 "On mandatory social insurance regarding to temporary disability and maternity". Depending on the disease and conditions of the employment contract, the time period is determined during which the insured person should be paid temporary disability benefits. The particular situations are specified, if the insured person has been recognized as disabled or contacted with infectious patients or with a person who has been identified as a bacteria carrier, or caring for a sick family member. Besides, the methodology for calculating the temporary disability benefits is revealed.

Relevance of research topic. Support for the proper functioning of the organizational and economic mechanism for the implementation of resort services to insured persons is an important factor in the development of the resort economy and the balanced development of the resort services market. This explains the relevance of the study.Formulation of the problem. The problem is the need to combine the market, social and resort components in the management of production processes and the implementation of these services. Analysis of recent research and publications. Many problems of management of public health through social insurance instruments are devoted to many scientific works. Beilik OO is investigating the topical issues of public health management through social insurance instruments. [2], Boberyeva O.V. [3], Gudz P.V. [4] Gulich O.I. [5], Zaburna L.V. [6], Zakharin S.V. [8], Stafiychuk V.I. [10], Fomenko N.V. [11] and others. Identification of unexplored parts of the general problem. The problems of management of public health improvement through social insurance instruments should be comprehended from the newest point, taking into account the need to maintain high social standards (on the one hand) and ambiguous political and economic situation in Ukraine (on the other hand). Setting the task, the purpose of the study. The purpose (key task) of this study is to develop conceptual foundations and proposals for improving the model of health improvement management through social insurance instruments. Method or methodology of conducting research. In the course of the research, general knowledge (analysis and synthesis, induction and deduction, analytical grouping, etc.) and special (abstraction, economic comparisons, statistical, etc.) methods and techniques of knowledge of economic phenomena and processes were used. Presentation of the main material (results of work). Support for the proper functioning of the organizational and economic mechanism for the implementation of resort services to insured persons is an important factor in the development of the resort economy and the balanced development of the resort services market. The health insurance program of insured persons is annually reassured, which may indicate a violation of the rights of insured persons and a reduction of the possibility of receiving sanatorium and resort services in accordance with the requirements of the legislation. One of the key factors hindering the growth of solvent demand for sanatorium and resort services accumulated with the use of funds from centralized social insurance funds is the lack of financial resources. Due to the orientation of the competition commissions on the price factor, sanatorium and resort establishments seek to form a competitive bid with the minimum possible price, thus offering tours with a minimum set of sanatorium and resort services, which in a large number of cases does not ensure proper sanatorium treatment of the insured person. Negative factor is the poor awareness of insured persons about the possibilities of sanatorium and spa treatment and health improvement at the expense of social insurance funds. The problem with regard to the possibility of applying a simplified procedure for the purchase of sanatorium and spa treatment services and medical rehabilitation of insured persons is acute. Conclusions according to the article: 1. The key task of regulation of resort activities is to support the mechanism of ensuring compliance with the rights of insured persons to quality sanatorium and resort services. 2. One of the factors hindering the growth of solvent demand for sanatorium and resort services accumulated with the use of funds from centralized social insurance funds is the lack of financial resources. The conditions of public procurement are constantly changing, which complicates the process of forecasting the list of sanatorium and spa establishments that will be able to provide sanatorium and resort services with the use of funds of social insurance funds. 3. The lack of scientifically substantiated methodological recommendations (or certain criteria) on the development of draft financial decisions regarding the financing of purchase of vouchers for sanatorium-resort and restorative treatment of insured persons is given. 4. It is advisable to develop a mechanism that would permit the purchase of vouchers for sanatorium and resort year for the first quarter of the following year in September-October this year. 5. An important issue is the improvement of the quality of sanatorium treatment services for insured persons. 6. The mechanism of compensation at the expense of the Fund of Social Insurance against accidents at work and occupational diseases in Ukraine suffered the cost of a trip, if the victim independently purchased a ticket according to medical indications to the sanatorium with which the contract was concluded.

Competition and state aid rules are not applicable to compulsory health insurance in the Republic of Croatia, since the latter does not constitute an economic activity as defined by EU law. On the other hand, complementary health insurance, as established in Croatia, constitutes an economic activity, due to the existence of real competition between undertakings. The illustrated situation with competition in complementary health insurance market allows for the statement that special rules applicable to Croatian Health Insurance Fund (HZZO) provide the latter with a privileged position when compared to its private competitors to whom these rules do not apply. Moreover, this privileged position is strengthened by the fact that HZZO, as a legal monopolist within the sphere of compulsory health insurance, utilizes respective infrastructure in the field of complementary health insurance, which enables it to reduce expenses to the detriment of its private competitors lacking such a privilege. A solution for the described situation could be for the state to establish a separate entity to provide complementary health insurance. This entity would have to provide open enrolment and community rating, regardless of age, sex or health of the insured persons. In order to prevent private competitors from jeopardising the exercise of service of general economic interest by taking over only the insured persons with a more favourable risk profile, a risk equalisation scheme would have to be set up. This would result in a transfer of funds from insurers with a favourable risk profile to those with an unfavourable risk profile on basis of objective and clear criteria, thereby making it possible for the latter to provide service to the higher-risk insured persons like the elderly and the ones with chronic illnesses. In this way, a balance between the necessity to provide a service of general economic interest to all insured persons, including those with a higher risk, and competition on the EU internal market, would be struck.

Background: It is unknown how subse­quent breast cancer outcomes vary by bio­logic subtype and race/ethnicity in a diverse cohort of breast cancer survivors.Methods: We conducted a prospective cohort study of 6,154 insured breast cancer survivors (AJCC TNM stages 0–IV) diagnosed between 1996-2007 and followed them through 1/1/2010 for subsequent breast cancer events (recurrence, contralateral breast cancer, metastasis, mortality). We compared subsequent breast cancer rates by race/ethnicity groups and biologic subtype (luminal A, luminal B, HER2-enriched, and triple negative). We calculated hazard ratios (HRs) with 95% CIs using multivariable Cox proportional hazards models, adjusted for sociodemographics, cancer treatments, and tumor characteristics.Results: The cohort was diverse: 62.4% non-Hispanic White, 13.2% Hispanic, 14.9% African American, and 9.5% Asian. We identified 1,456 subsequent breast cancer events over 22,830 person-years. Although certain Asian women had higher crude subsequent breast cancer rates com­pared with Whites, within each biologic subtype category, these disparities disap­peared in the multivariable analyses. After accounting for race/ethnicity, compared with women with luminal A tumors (refer­ence), women with luminal B (adjusted HR=3.65, 95% CI: 3.08-4.32), HER2- enriched (adjusted HR=2.81, 95% CI: 2.25-3.51) and triple negative (adjusted HR=1.25, 95% CI: 1.01-1.54) tumors had statistically increased risks of subsequent breast cancer. Factors that were statistically significantly associated with increased risk included higher stage, larger tumor size, positive lymph nodes, and no adjuvant endocrine or chemotherapy (all P<.025).Discussion: Our data suggest that dispari­ties in subsequent breast cancer outcomes were more strongly associated with tumor characteristics and non-use of adjuvant treatments than race/ethnicity. Ethn Dis. 2018;28(4):565-574; doi:10.18865/ed.28.4.565.