SOME PARTICULAR LEGAL ISSUES OF ENFORCEMENT OF CONTRACTS IN VOLUNTARY MEDICAL INSURANCE

Abstract

The article is devoted to the analysis of the current legislation and law enforcement
practice on the execution of voluntary medical insurance contracts. In this regard, the articles of
the Civil Code of the Russian Federation and the Russian Federation Law of 27.11.1992, No. 4015–1
«On the insurance business organization in the Russian Federation», which mainly regulate relations
in the area of voluntary medical insurance, are analyzed. The article deals with the problems of
the legal regulation of voluntary medical insurance, the implementation of measures to control the
provision of medical services under voluntary medical insurance contracts, as well as the problem
of meeting the deadlines for payment of services provided by medical organizations. A review of
the legal regulation of voluntary medical insurance has shown that the existing acts are not very
suitable for regulating voluntary health insurance relations and do not take into account its specifics.
Voluntary medical insurance is governed mainly by insurance regulations, a voluntary medical insurance
contract and contracts for the provision of medical services for voluntary medical insurance.
To a greater extent this concerns the provision of medical and other services for voluntary medical
insurance. Analysis of the provision of the rights of the insured to medical care under voluntary
medical insurance contracts indicates that the legislation does not provide a list of basic guarantees
for insured persons and policyholders when they seek medical assistance under the voluntary medical
insurance programs. Appeal to actual problem of monitoring the provision of medical services
under voluntary medical insurance contracts led to the conclusion that the current issues of this type
of activity of the insurer were not reflected in the legislation, which gives rise to disputes between
insurers and medical institutions. Based on the analysis made, proposals were made to improve the
legislation of the Russian Federation in terms of ensuring the rights of the insured to medical care
under voluntary medical insurance contracts.