Medical insurance is carried out in the form of an agreement concluded between entities health insurance. Subjects of health insurance fulfill obligations under the concluded contract in accordance with the law Russian Federation.

A health insurance contract is an agreement between the insured and a medical insurance organization, according to which the latter undertakes to organize and finance the provision of medical care to the insured population of a certain volume and quality or other services under compulsory health insurance and voluntary health insurance programs.

The health insurance contract must contain:

· names of the parties;

· duration of the contract;

· number of insured;

· size, terms and procedure for making insurance contributions;

· list of medical services corresponding to compulsory or voluntary health insurance programs;

· rights, obligations, responsibilities of the parties and other conditions that do not contradict the legislation of the Russian Federation.

The health insurance contract is considered concluded from the moment of payment of the first insurance premium, unless otherwise provided by the terms of the contract.

If the policyholder loses the rights of a legal entity during the period of validity of the compulsory health insurance contract as a result of the reorganization or liquidation of the enterprise, the rights and obligations under the specified contract pass to its legal successor.

During the period of validity of the voluntary medical insurance contract, if the court recognizes the insured as incompetent or limited in legal capacity, his rights and obligations are transferred to the guardian or trustee acting in the interests of the insured.

62. The essence and fundamentals of reinsurance

Reinsurance is a necessary condition for ensuring financial stability insurance operations and normal activities of any insurance company. It is known that insurance is based on the theory of probability and the law of large numbers. According to this law, the combined action of a large number of random factors leads, for some very general conditions to a result almost independent of chance. Randomness appears as a pattern. In most cases, insurance companies are not able to create a perfectly balanced portfolio of risks, since the number of insurance objects is small or the portfolio contains large and dangerous risks that introduce elements of disproportion into the portfolio. In addition, practice shows that any insurance company, even with careful selection of risks when accepting them for insurance, cannot create a portfolio of insurance objects completely isolated from each other, since the insurance conditions usually cover various dangers to which the insured objects may be exposed simultaneously in the event of a catastrophe. : floods, hurricanes, earthquakes, devastating fires, etc. However, due to the fact that financial resources and even all the assets of any insurer constitute only a small fraction of the total amount of its liability to policyholders for the entire portfolio of insured objects, these catastrophes (insured events) can not only significantly undermine the financial base of the insurance company, but also lead it to complete bankruptcy.

To equalize the insured amounts of risks accepted for insurance and thereby balance insurance portfolio, bringing the potential liability for the total insured amount in accordance with the financial capabilities of the insurer and, therefore, to ensure the financial stability of insurance operations and their profitability, obtaining mutual participation in the risks accepted for insurance by other insurers, there is an institution of reinsurance.

Reinsurance is a system of economic relations in which the insurer, accepting risks for insurance, transfers part of the responsibility for them (taking into account its financial capabilities) on agreed terms to other insurers in order to create a balanced portfolio of insurance contracts, ensure financial stability and profitability of insurance operations.

Reinsurance achieves not only the protection of the insurance portfolio from the impact of a series of large insured events or even one catastrophic event, but also the fact that payment of insurance compensation for such cases does not place a heavy burden on one insurance company, but is carried out collectively by all participants.

An insurer that has accepted a risk for insurance and transferred it in whole or in part for reinsurance to another insurer is called reinsurer or assignor. The insurer that has accepted reinsurance risks is called reinsurer. Assistance in transferring risk to reinsurance is often provided by reinsurance broker. Having accepted a risk under reinsurance, the reinsurer can partially transfer it to a third insurer. This operation is usually called retrocession, and the reinsurer transferring the risk into retrocession - retro-assignee.

During the period of scientific and technological progress there is a colossal concentration material assets and, consequently, an increase in insurance amounts for a large number insurance objects: carrying capacity is increasing sea ​​vessels and as a result of this, the cost of the ships themselves and the cargo transported on them, giant factories are built, the cost of long-haul aircraft increases significantly, etc. No insurance company can accept such large risks without having solid reinsurance coverage in excess of the amounts that it will hold on its responsibility.

In many cases insurance costs insured risks are so great (or dangerous) that the capacity individual markets turns out to be insufficient to provide insurance in full amounts.

Rebuilding is a building special type. Its content consists in transferring part of the risk(s) in response to another specialized builder, i.e. rebuilder. An insurer that directly works with policyholders to assume their risks is called a “direct insurer,” or an insurer who transfers risks. The process of transferring part of the risks assumed to other insurance companies in order to create a portfolio that would ensure the stability and profitability of operations is called restructuring.

A rebuilder is a builder who provides insurance service"to the direct builder."

The process of transferring risk is called risk assignment or insurance assignment. The person who transfers the risk is called the assignor, and the one who accepts this risk is called the assignee.

According to the form of mutual obligations of the reinsurer and reinsurance, reinsurance agreements are divided into: optional (optional); obligatory (mandatory); facultative-obligatory, or “open coverage” contracts, obligatory-facultative

Optional rebuild

The optional restructuring agreement concerns one risk in one transaction. This rebuild allows the rebuilder to get an accurate idea of ​​what is being offered to him. separate risk, before accepting obligations under the reinstatement contract. The direct insurance offer for optional reinstatement must contain all relevant information about the risk that would allow the rebuilder to correctly assess it. After the rebuilder Having studied the information related to the risk, he informs the direct insurer what percentage or amount he will accept in the optional restructuring.

Typically, confirmation is made by telephone, fax, or by sending a signed copy of the proposal indicating the share to which the rebuilder agrees. The terms of the agreement concluded in this way are usually determined after some time. again in writing signed by both parties.

The rebuilder may refuse the proposed risk. It is enough for him to briefly outline the reasons for the refusal. He may also offer the direct insurer other conditions than those specified in the offer. If the rebuilder does not respond to the proposal, his silence cannot be considered as acceptance.

The optional restructuring agreement comes into force from the moment of receipt of acceptance, unless the parties agree otherwise. Significant changes in the terms of the direct contract during the period of its validity are obligatory for the reinsurer only if he has given his consent.

The optional restructuring agreement terminates automatically upon expiration deadline, unless the parties agree otherwise. For a certain period before renewal, the direct builder, as a rule, offers the rebuilder to extend the validity of the agreement and informs him about changes in the terms of the direct agreement and about the statistics on the passage of the agreement. The rebuilder may refuse to prolong the contract.

Obligatory restructuring

Reinsurers receive a significant amount of reinsurance premium under obligatory reinsurance contracts.

Obligatory reinsurance establishes a closer connection between the parties than single reinsurance cessions. The most important principles of obligatory reinsurance were formed thanks to reinsurance with the determination of participation shares and excess reinsurance. Not all of them are valid in relation to disproportionate restructuring, which is carried out on an obligatory basis.

According to the obligatory restructuring agreement, the assignor undertakes to transfer to the restructuring all the risks described in detail, i.e. The rebuilder obligated to accept such risks is not defined. and does not assess risk on a case-by-case basis.

The assignor has ownership. the right to accept risks at its own discretion and determine the insurance premium. In addition, he must regulate losses as he sees fit in the general interests of insurance and reinsurance. The scope and extent of the obligation to follow the actions of the assignor corresponds to the right of the assignor to manage its business.

Reinsurance payments under the obligatory reinsurance agreement defined. as a percentage of the amount of payments received by the builder upon the mortgage. direct agreement.

The obligatory restructuring agreement is concluded for an indefinite period with the right of mutual termination. Such a contract is beneficial for the assignor, since all predetermined risks are automatically covered by the reinsurer.

Related information.

In accordance with legislative framework In the Russian Federation, health insurance has two forms: mandatory and voluntary. Compulsory health insurance (CHI) is based on monthly payments unified social tax and applies to all citizens of Russia. Voluntary health insurance (VHI) provides additional receipt medical services in addition to the compulsory medical insurance program.

Relations between health insurance participants are regulated by a health insurance agreement, which is concluded between the insurance entities. In accordance with the terms of the health insurance contract, the parties bear obligations stipulated by the legislation of the Russian Federation.

A health insurance contract is an agreement between the insurer (medical insurance organization) and the policyholder. In accordance with the terms of the contract, the medical organization assumes the responsibility for organizing and financing the provision of medical care to insured persons under the voluntary and compulsory health insurance program.

Compulsory health insurance

Insured persons (citizens of the Russian Federation) are guaranteed the right to receive free medical services under compulsory medical insurance (compulsory health insurance), which is implemented under agreements concluded in their favor between participants in compulsory health insurance.

Compulsory health insurance agreement

Agreements are concluded between medical organizations included in the register of medical organizations and participating in the implementation of territorial compulsory medical insurance programs, and medical insurance organizations also participating in the implementation of territorial compulsory medical insurance programs.

Medical organizations, guided by a health insurance contract, guarantee to provide medical care to insured persons within the framework of territorial compulsory medical insurance programs. Medical insurance organizations undertake to pay for such medical services provided within the framework of territorial programs.

Provisions of the compulsory medical insurance agreement

The contract of compulsory medical insurance contains provisions that provide for the responsibilities of medical insurance organizations:

• receive all necessary information from medical organizations regarding the provided and planned medical care to insured persons;
• carry out control over the volumes, timing, quality and conditions of providing medical services in medical organizations;
• organize the provision of medical care for insured persons in other medical organizations.

Mandatory provisions for medical organizations:

• provide information for medical insurance organizations about the insured person and the volume, timing and quality of medical care provided to him;
• submit a register of invoices for medical services provided;
• report on use Money for compulsory health insurance for the Federal Fund;
• perform other duties provided for by federal legislation.

Important!

The insured person has the right to independently choose a medical organization to conclude a compulsory medical insurance agreement with it by an insurance medical organization.

The financial side of health insurance

Payment for medical care is carried out in accordance with the tariffs for payment for medical care and the procedure for payment for medical services provided under compulsory medical insurance, established by the rules of compulsory medical insurance.

Non-payment or late payment for medical care is paid in full by the medical insurance organization according to the submitted requirements (including penalties for each overdue day) at its own expense.

For untimely provision (provision of inadequate quality) or failure to provide medical care under a health insurance contract, the medical organization shall pay a fine in the amount specified in the insurance contract. For medical organizations (in accordance with federal legislation), penalties are provided for the misuse of funds received.

The compulsory health insurance contract is considered terminated in the following cases:

• termination (suspension) of a license or liquidation of a medical insurance organization;
• loss by a medical organization of its right to carry out medical activities.

Standard contract form

The form of the compulsory health insurance contract is approved by special authorized federal bodies.

Voluntary health insurance agreement

In voluntary health insurance, the object of insurance is the risk that incurs the costs of providing medical care in the event of an insured event.

The health insurance contract must contain the following conditions:

• subjects of health insurance;
• a list of medical services included in the medical assistance program;
• total number of insured persons;
• sum insured;
• insurance premium (procedure, size and timing of making insurance contributions);
• rights and obligations of participants in insurance legal relations;
• contract time.

The health insurance contract comes into force from the moment of payment of the first insurance premium. The validity period of the agreement is established by agreement of the parties, but cannot be less than one year. The rights and obligations of the policyholder may pass to a trustee or guardian acting in the interests of the insured person if the policyholder is recognized as having limited legal capacity or incapacity during the insurance period.

The voluntary health insurance agreement is concluded with the aim that employees of different companies can receive medical care at a higher level compared to the services provided in free clinics and hospitals.

Dear readers! The article talks about typical ways to resolve legal issues, but each case is individual. If you want to know how solve exactly your problem- contact a consultant:

APPLICATIONS AND CALLS ARE ACCEPTED 24/7 and 7 days a week.

It's fast and FOR FREE!

What is this

A VHI agreement is an official document concluded between two parties - an insurance organization (insurer) and various companies (insured).

According to this agreement, the insurer is obliged to organize and sponsor the provision of medical care to the policyholder under selected programs. The policyholder must pay a fixed amount of money under the contract for medical services.

A voluntary health insurance contract may include one or more services based on the selected program.

The difference between a compulsory health insurance agreement and a voluntary health insurance agreement

• the VHI agreement assumes that the patient is provided with a higher quality level of medical care;
• a VHI agreement differs from a compulsory health insurance agreement in that it is concluded for a specific, limited list of services;
• Compulsory medical insurance is issued free of charge to all citizens of the country and is a mandatory part of state insurance, and a VHI policy is purchased for money on the personal initiative of citizens, or VHI is included in the social package from work;
• The compulsory medical insurance policy is limited to a certain standard set of free medical services in the clinic; Voluntary medical insurance has expanded capabilities, allowing you to receive Additional services along with guaranteed ones;
• in compulsory medical insurance, the conditions are determined by the state, in voluntary medical insurance, all tariffs and programs are prescribed by insurance companies;
• in compulsory medical insurance the sources of funds are the state budget, and in voluntary health insurance contributions from employers.

The voluntary health insurance agreement must spell out all the subtleties and nuances of its execution.

It must be in writing and contain a certain list of requirements, without which it will be declared invalid.

Contract time

All terms are discussed by two persons - a representative of the insurance company and the head of the company. It is usually concluded annually. If the contract does not specify the terms, it is considered invalid.

The contract specifies a special period called the waiting period. According to it, the insurer must be liable in the event of an insured event, but after the end of such a period.

The contract begins to be valid from the date of signing, but another option is possible - it comes into force after the first payment for medical insurance services.

Number and names of insured persons

There are two types of VHI: collective and individual.

Depending on the type, before drawing up the contract, an application must be filled out:

• for a company employee - if this is a collective voluntary health insurance agreement;
• for the policyholder personally, for his family members - an individual contract.
• When a contract is concluded for employees of an organization, the employer, the head of the company, acts as the insured, and the employees of the company act as the insured persons.

Types of insurance cases

The contract must necessarily include types of insured events. In that official documents All exceptions must also be indicated, in those cases that do not apply to insurance.

Insured events include the patient seeking help from a clinic that is included in the list of those included in the voluntary insurance program.

The contract may provide for the provision different types assistance, both individually and jointly: from dental, outpatient to emergency and ambulance. The list of services is included in the annex to the contract.

Exceptions include the provision of medical care in case of injury in an inadequate state - alcohol or drugs.

Amount, terms and procedure for making insurance contributions

These conditions in the voluntary health insurance agreement must be clearly stated, without vague phrases and unclear, florid interpretation, so that there are no misunderstandings.

For example, if payment for insurance services was made untimely, the contract becomes invalid.

In accordance with the VHI agreement, insurance premiums can be paid at a time - in one lump sum or in several installments - by installments.

Sum insured

Receive insurance payments the person in whose favor the contract is concluded has the right.

In case of insured event the insured person must receive assistance from the doctors of those clinics specified in the contract, and the medical institution must receive payment for the services provided in accordance with the agreed tariffs.

According to the contract, the list of services may change and vary, and in connection with this, the policyholder may change the amount of the insured amount by signing additional agreements with the insurer.

Rights, obligations and responsibilities of the parties

A company that insures its employees has the right to:

• check the availability of services provided in medical institutions and their validity.
• check whether the information provided by the policyholder in the contract is correct;
• refuse payment for services if this is provided for in the contract.

An insurance organization has its own rights - to make demands on its insurers to provide medical services to insured persons only in those clinics and hospitals that are prescribed in the VHI insurance contract.

Responsibilities of the insurer

• create the necessary conditions for the provision of medical services in accordance with the chosen program;
• issue policies to insured citizens;
• not to disclose personal data of persons;
• make payments for services on time - within the terms specified in the contract.

The policyholder is obliged

• if it is impossible to provide services, notify the insurer;
• provide complete information when concluding contracts about all circumstances and factors that may, in one way or another, affect the assessment of insurance risk;
• pay the insurance company on time.

Conclusion procedure

To conclude a VHI agreement, an application is submitted, which is drawn up directly for the policyholder, representatives of his family or for company employees in case of group insurance.

The application must include all personal information that may be required to select a program and its cost.

These include:

• professional field of activity;
• Family status;
• health status - presence of chronic diseases, injuries, past illnesses, physical condition;
• age;
• place of residence.

When signing an agreement that contains increased guarantees, which are the most highly paid, the application should include additional information of the following nature:

• at what age did the parents die?
• predisposition to diseases;
• whether the patient has hereditary diseases;
• results of basic tests - blood, urine, etc.;
• extracts from medical history. May need to go
  additional examinations.

All this is required to be provided to the insurance organization when concluding an individual agreement, but if collective agreement, then everything will be much simpler.

And you will not need to provide any additional information or papers.

After receiving the application, the insurance organization has the right:

• refuse to insure a person if there are objective reasons for this;
• take a risk without changing the terms of the contract, i.e. on standard terms;
• take risks by increasing tariffs and stipulating special conditions in the contract.

The application that must be filled out to create a VHI agreement specifies the period during which the document will be considered valid:

• a certain period of time - a trip abroad;
• specific period - 1 year -10 years;
• indefinite term.

Who concludes

Such an agreement is concluded between an organization operating in any field and regardless of the number of employees working in it and the insurance company.

Medical policies will be used by employees of the organization that has decided to insure the health of its clients.

Under a VHI contract, the insurance company undertakes to provide medical care in accordance with the chosen program.

Collective agreement

A collective agreement is concluded between a company of any field of activity, any number of employees and an insurance company.

An individual VHI program is drawn up for each client, based on the wishes of the policyholder.

The huge advantage of this type of insurance is that thanks to its existence you can insure for preferential terms at cheaper rates than in the case of an individual agreement.

Individual

Concluding an individual VHI agreement is not as profitable as a collective one, because Insurance premium payments will be much higher, and it will no longer be the employer who will have to pay, but you personally, your family members.

Price VHI policy will depend on the insurance program you choose and specified in the contract, your age, and the presence of health problems.

They exist separately special programs for insurance of elderly people, students, children and other persons.

Regardless of what kind of agreement was concluded: individual or collective, you will have a policy in your hands, according to which you will be able to seek help from the medical institutions specified in the agreement.

Health insurance is carried out in the form of an agreement concluded between the subjects of health insurance. Subjects of health insurance fulfill their obligations under the concluded contract in accordance with the legislation of the Russian Federation.

A health insurance contract is an agreement between the insured and a medical insurance organization, according to which the latter undertakes to organize and finance the provision of medical care to the insured population of a certain volume and quality or other services under compulsory health insurance and voluntary health insurance programs.

The health insurance contract must contain the following essential conditions:

• - names of the parties;
• - duration of the contract;
• - number of insured;
• - size, terms and procedure for making insurance contributions;
• - a list of medical services corresponding to compulsory or voluntary health insurance programs;

Rights, obligations, responsibilities of the parties and other conditions that do not contradict the legislation of the Russian Federation.

Forms standard contracts compulsory health insurance for workers and unemployed citizens are given in Appendices No. 1 and No. 2 to the Resolution of the Council of Ministers of the Russian Federation of October 11, 1993 No. 1018 (with the latest amendments and additions).

The health insurance contract is considered concluded from the moment of payment of the first insurance premium, unless otherwise provided by the terms of the contract.

If the policyholder loses the rights of a legal entity during the period of validity of the compulsory health insurance contract as a result of the reorganization or liquidation of the enterprise, the rights and obligations under the specified contract pass to its legal successor.

During the period of validity of the voluntary medical insurance contract, if the court recognizes the insured as incompetent or limited in legal capacity, his rights and obligations are transferred to the guardian or trustee acting in the interests of the insured.

Every citizen in respect of whom a health insurance contract has been concluded or who has concluded such an agreement independently receives a medical insurance policy. The medical insurance policy is in the hands of the insured.

The medical insurance policy is valid throughout the Russian Federation, as well as in the territories of other states with which the Russian Federation has agreements on medical insurance of citizens.

Medical institutions are responsible for the volume and quality of medical services provided and for refusal to provide assistance to the insured person. In case of violation of the terms of the contract Compulsory medical insurance insurance A medical organization has the right not to partially or fully reimburse the costs of providing medical services.

Disputes regarding compulsory health insurance are resolved by the courts within their competence.

Health insurance contract

Health insurance is carried out in the form of an agreement concluded between the subjects of health insurance. Subjects of health insurance fulfill their obligations under the concluded contract in accordance with the legislation of the Russian Federation.

A health insurance contract is an agreement between the policyholder and a medical insurance organization, according to which the latter undertakes to organize and finance the provision of medical care to the insured population of a certain volume and quality or other services under compulsory and voluntary health insurance programs.

The health insurance contract must contain:

* names of the parties;

* duration of the contract;

* number of insured;

* size, terms and procedure for making insurance contributions;.

*list of medical services corresponding to compulsory or voluntary health insurance programs;

* rights, obligations, responsibilities of the parties and other conditions that do not contradict the legislation of the Russian Federation.

The form of standard contracts for compulsory and voluntary medical insurance, the procedure and conditions for their conclusion are established by the Government of the Russian Federation.

The health insurance contract is considered concluded from the moment of payment of the first insurance premium, unless otherwise provided by the terms of the contract.

If the policyholder loses the rights of a legal entity during the period of validity of the compulsory health insurance contract as a result of the reorganization or liquidation of the enterprise, the rights and obligations under the specified contract pass to its legal successor.

During the period of validity of the voluntary medical insurance contract, if the court recognizes the insured as incompetent or limited in legal capacity, his rights and obligations are transferred to the guardian or trustee acting in the interests of the insured.

Every citizen in respect of whom a health insurance contract has been concluded or who has concluded such an agreement independently receives a medical insurance policy, which is constantly in his hands.

The medical insurance policy is valid throughout the Russian Federation, as well as in the territories of other states with which the Russian Federation has agreements on medical insurance of citizens.

In the health insurance system, citizens of the Russian Federation have the right to:

* compulsory and voluntary health insurance;

* selection of a medical insurance organization;

* selection of a medical institution and doctor in accordance with compulsory and voluntary health insurance contracts;

* receiving medical care throughout the Russian Federation, including outside your permanent place of residence;

* receiving medical services that correspond in volume and quality to the terms of the contract, regardless of the amount of the insurance premium actually paid;

* filing a claim against the insured, medical insurance organization, medical institution, including for material compensation for damage caused through their fault, regardless of whether this is provided for in the medical insurance contract or not;

refund of part of the insurance premiums for voluntary medical insurance, if this is determined by the terms of the contract.

Rules regarding compulsory health insurance established by legislative acts and adopted in accordance with them regulations, apply to working citizens from the moment an employment contract is concluded with them.

On the territory of the Russian Federation, stateless persons have the same rights and obligations in the health insurance system as citizens of the Russian Federation.

Medical institutions, in accordance with the legislation of the Russian Federation and the terms of the contract, are responsible for the volume and quality of medical services provided and for refusal to provide medical care to the insured party. If a medical institution violates the terms of the contract, the medical insurance organization has the right not to partially or fully reimburse the costs of providing medical services.

The insurance organization bears legal and financial liability to the insured person or policyholder for failure to comply with the terms of the health insurance contract. Financial liability is provided for by the terms of the health insurance contract.

Payment for services of medical institutions by insurance organizations is made in the manner and within the time limits stipulated by the agreement between them, but no later than a month from the date of submission of the payment document. Responsibility for failure to make payments on time is determined by the terms of the health insurance contract.

For an unreasonable refusal to conclude a compulsory health insurance contract, a medical insurance organization may, by a court decision, be deprived of its license to engage in health insurance.

An insurance medical organization has the right to demand from legal or individuals responsible for harm caused to the health of a citizen, reimbursement of expenses within the limits of the amount spent on providing medical care to the insured; assistance, except in cases where the damage was caused by the insured.

Healthcare financing in the context of health insurance is carried out according to the scheme presented in Fig. 3

Fig.3. Sources of healthcare financing in the Russian Federation

To sources financial resources healthcare systems in the Russian Federation include:

* funds from the republican budget, budgets of the republics within the Federation;

* government and public organizations(associations), enterprises and other economic entities;

* personal funds of citizens;

* free and (or) charitable contributions and donations;

* income from valuable papers;

* loans from banks and other lenders;

* other sources not prohibited by the legislation of the Russian Federation.

From these funds, independent healthcare funds and health insurance funds are formed, as well as financial resources of the state and municipal healthcare systems, financial resources state system compulsory health insurance

Act as medical insurance organizations legal entities who are independent economic entities of any property provided for by law, possessing the necessary for the implementation of health insurance authorized capital and organizing their activities in accordance with the legislation of the Russian Federation. Insurance medical organizations are not part of the health care system.

Health care management bodies and medical institutions do not have the right to be founders of medical insurance organizations, but have the right to own shares of medical insurance organizations. The total share of shares owned by healthcare management bodies and medical institutions should not exceed 10% of the total shareholding of the medical insurance organization. A medical insurance organization has the right:

* freely choose medical institutions to provide medical care and services under health insurance contracts;

* participate in the accreditation of medical institutions;

* establish the amount of insurance premiums for voluntary health insurance;

* take part in determining tariffs for medical services;

* bring a lawsuit against a medical institution and/or medical worker for material compensation for physical and/or moral damage caused to the insured through their fault

The medical insurance organization is obliged to:

* carry out compulsory health insurance activities on a non-commercial basis;

* enter into agreements with medical institutions to provide medical care to those insured under compulsory health insurance;

* enter into agreements for the provision of medical, health and social services to citizens under voluntary health insurance with any medical or other institutions;

* from the moment of concluding a health insurance contract, issue insurance to the policyholder or the insured medical policies;

* refund part of the insurance premiums to the policyholder or the insured, if this is provided for in the health insurance contract;

* control the volume, timing and quality of medical care in accordance with the terms of the contract;

* protect the interests of the insured.

A medical insurance organization does not have the right to refuse the policyholder to enter into a compulsory health insurance agreement that complies current conditions insurance.

Medical insurance organizations are reorganized and liquidated in the manner established by the legislation of the Russian Federation.

Medical care in the health insurance system is provided by medical institutions with any form of ownership, accredited in the prescribed manner. They are independent economic entities and base their activities on the basis of agreements with medical insurance organizations.

Under licenses, medical institutions implement voluntary health insurance programs without prejudice to compulsory health insurance programs.

Medical institutions implementing health insurance programs have the right to provide medical care outside the health insurance system.

Medical institutions in the health insurance system have the right to issue documents certifying the temporary disability of the insured.

All medical institutions, regardless of their form of ownership, are subject to licensing.

A license is a state permit for a medical institution to carry out certain types of activities and services under compulsory and voluntary health insurance programs.

Licensing is carried out by licensing commissions created under government bodies, city and district local administrations from representatives of healthcare authorities, professional medical associations, medical institutions, public organizations (associations). Accreditation of medical institutions is the determination of their compliance with established professional standards. All medical institutions, regardless of their form of ownership, are subject to accreditation. Accreditation of medical institutions is carried out by accredited commissions created from representatives of healthcare authorities, professional medical associations, and medical insurance organizations.