RESPONSIBILITIES OF THE PARTIES IN THE HEALTH INSURANCE CONTRACT IN CASE OF ILLNESS

Abstract

The article, based on the current legislation of Ukraine governing contractual relations in the insurance sector and an analysis of scholarly works, defines and elucidates the concept of party liability in health insurance contracts for illness. A distinction is made regarding the liability of parties within the system of contracts that regulate contractual relations in the insurance domain. The legal characteristics of party liability in health insurance contracts for illness are examined, including the delineation of obligations, grounds for avoiding or exempting liability, methods of resolving liability-related issues (including alternative approaches), and the consequences for parties upon exemption from liability or, conversely, upon the imposition of specific liability measures. The need to update regulatory acts in the field of health insurance for illness concerning party liability is identified. Arguments are presented for establishing in Ukrainian legislation the procedure and framework for holding a party accountable for improper fulfillment of contractual obligations in health insurance agreements, considering the martial law in Ukraine and the consequences of war. The possibility of simplifying the protection of the policyholder's rights is explored, including the proposal to exempt policyholders from court fees when pursuing claims against insurers for failure to fulfill health insurance contract terms. The distinction between the liability of policyholders and insurers under health insurance contracts for illness is clarified in light of the applicable legislation of Ukraine. The article emphasizes that the disclosure of the concept, types, and consequences of holding parties liable under health insurance contracts for illness holds significant theoretical and practical importance. This contributes to a clearer understanding and precise definition of mechanisms for protecting parties from intentional or unintentional avoidance of fulfilling the terms and obligations specified in health insurance contracts for illness.