magistrska naloga
Andreja Verk Završnik (Avtor), Etelka Korpič-Horvat (Mentor)

Povzetek

V magistrskem delu proučujem regresne zahtevke Zavoda za zdravstveno zavarovanje Slovenije zoper delodajalca, zaradi neizvedenih ustreznih ukrepov varstva pri delu. Gre za odškodninsko odgovornost delodajalca na podlagi 87. člena Zakona o zdravstvenem varstvu in zdravstvenem zavarovanju. Obvezno zdravstveno zavarovanje je v Republiki Sloveniji enotno, kar pomeni, da se z njim zagotavljajo pravice ob nastanku poškodbe in bolezni izven dela kot tudi ob nastanku poškodbe ali poklicne bolezni. Zavarovanje se izvaja po načelih socialne pravičnosti in solidarnosti. Zavarovanje je obvezno za vse osebe, ki izpolnjujejo z zakonom predpisane pogoje. Zavarovane osebe imajo ob nastopu zdravstvenega primera pravice do dajatev v naravi in denarju, ki se krijejo iz obveznega zdravstvenega zavarovanja. Sredstva za obvezno zdravstveno zavarovanje se zagotavljajo s prispevki, ki jih plačujejo zavarovanci, delodajalci in drugi z zakonom določeni zavezanci. Vseh nezgod pri delu delodajalci ne morejo preprečiti, vendar lahko višjo raven varnosti in zdravja pri delu dosežejo z odpravljanjem in zmanjševanjem tveganj, ki so jim delavci med svojim delom izpostavljeni. Glavna naloga delodajalca je, da zagotovi, kolikor je izvedljivo, da so delovna mesta, stroji, oprema in procesi pod njihovim nadzorom varni in brez nevarnosti za zdravje in poškodbe. Nespoštovanje predpisov s področja varnosti in zdravja pri delu in tudi drugih predpisov, sprejetih za varnost ljudi, pomeni poleg kazenske tudi odškodninsko odgovornost delodajalca. Opustitev varnosti in zdravja pri delu povzroča povečane izdatke, ki se kažejo tudi v zdravstveni blagajni. Tako je delodajalec na področju zdravstvenega zavarovanja odškodninsko odgovoren Zavodu za zdravstveno zavarovanje Slovenije, če je bolezen, poškodba ali smrt zavarovane osebe posledica tega, ker niso bili izvedeni ustrezni higiensko-sanitarni ukrepi, ukrepi varstva pri delu ali drugi ukrepi, predpisani ali odrejeni za varnost ljudi in v kolikor je bilo delovno razmerje sklenjeno brez predpisanega zdravstvenega pregleda z osebo, ki zdravstveno ni bila sposobna za opravljanje določenih del oziroma nalog, kar se je pozneje ugotovilo z zdravstvenim pregledom. Jedro proučevanja se nanaša na pravno ureditev regresnih zahtevkov Zavoda za zdravstveno zavarovanje Slovenije napram delodajalcu. Posebno pozornost v magistrskem delu namenjam tudi ureditvi obveznega zdravstvenega zavarovanja in varnosti in zdravja pri delu ter samemu oblikovanju regresnega zahtevka s strani Zavoda za zdravstveno zavarovanje Slovenije, in sicer z vidika določitve višine škode in presoje delodajalčevih kršitev. Proučujem tudi primere regresnih zahtevkov in sodno prasko s predmetnega področja. V povezavi z odgovornostjo delodajalca proučujem tudi možnost izključitve odškodninske odgovornosti delodajalca v primeru male malomarnosti, in sicer z vidika kritja stroškov iz sredstev Zavoda za zdravstveno zavarovanje Slovenije in sredstev komercialnih zavarovalnic na podlagi zavarovanja delodajalčeve odgovornosti. Na podlagi zaključkov v magistrskem delu podajam ugotovitve povezane z izključitvijo odškodninske odgovornosti za malo malomarnost delodajalca in predlog, da se z zakonom določi, da so v zavarovanje odgovornosti vključeni tudi regresni in odškodninski zahtevki Zavoda za zdravstveno zavarovanje Slovenije, kakor je to določeno že na drugih področjih (na primer na področju prometa).

Ključne besede

zdravstveno zavarovanje;prispevki za zdravstveno zavarovanje;varnost in zdravje pri delu;nezgoda pri delu;poškodba pri delu;odškodninska odgovornost delodajalca;povrnitev škode;regresni zahtevek;zavarovanje odgovornosti delodajalca;diferencirana prispevna stopnja;magistrske naloge;

Podatki

Jezik: Slovenski jezik
Leto izida:
Tipologija: 2.09 - Magistrsko delo
Organizacija: UM PF - Pravna fakulteta
Založnik: [A. Verk Završnik]
UDK: 364.32(043.2)
COBISS: 5184299 Povezava se bo odprla v novem oknu
Št. ogledov: 1366
Št. prenosov: 204
Ocena: 0 (0 glasov)
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Ostali podatki

Sekundarni jezik: Angleški jezik
Sekundarni naslov: Recourse claim by the Health Insurance Institute of Slovenia against the employer due to the failure to perform the relevant safety at work measures
Sekundarni povzetek: The master’s thesis deals with recourse claims by the Health Insurance Institute of Slovenia against the employer due to the failure to perform the relevant safety at work measures. This is a liability for damages of the employer based on Article 87 of the Slovenian Law on Health Care and Health Insurance. In the Republic of Slovenia, the compulsory health insurance is unified, thus it ensures the rights in case of injury and illness outside of work, as well as in case of work-related injury or illness. The insurance is carried out according to the principles of social justice and solidarity. It is compulsory for all persons fulfilling the conditions determined by law. At the occurrence of a health-related event, insured persons are entitled to the coverage of natural and monetary costs by the compulsory health insurance. The compulsory health insurance funds are provided through contributions which are paid by the insured persons, employers or other legally liable persons. The employers cannot prevent all work-related accidents, but they can achieve a higher level of health and safety at work by eliminating and reducing the risks the employees are exposed to during their work. The main responsibility of the employer is to ensure, in the extent possible, that the working areas, machines, equipment and processes under their supervision are safe and do not pose health or injury risks. In case of the failure to comply with the regulations for health and safety at work, which were adopted to ensure the safety of people, the employer assumes criminal liability, as well as the liability for damages. The failure to ensure health and safety at work increases costs, which also has consequences for the health insurance fund. Thus the employer assumes the liability for damages in the area of health insurance towards the Health Insurance Institute of Slovenia, if the illness, injury or death of an insured person was caused by the failure to perform the relevant hygienic and sanitary measures, safety at work measures or other measures, prescribed or imposed to ensure the safety of people or if the employment relationship was concluded without the mandatory medical examination with a person who was not in the right medical condition to perform certain work or tasks, which was later established in a medical examination. The thesis focuses on the legal arrangement of recourse claims by the Health Insurance Institute of Slovenia against the employer. The thesis also focuses on the arrangement of the compulsory health insurance and health and safety at work, as well as on the formation of the recourse claim by the Health Insurance Institute of Slovenia, namely from the aspect of assessing the height of the damage and the employer’s violations. Examples of recourse claims and the relevant case law are also discussed. In relation to the liability of the employer, the thesis also discusses the possibility of the exclusion of liability for damages of the employer in case of minor negligence, namely from the aspect of the coverage of costs from the funds of the Health Insurance Institute of Slovenia and the funds of commercial insurance companies based on the insurance of the employer’s liability. Based on the findings, the master’s thesis provides conclusions with regard to the exclusion of the liability for damages due to a minor negligence by the employer, as well as a proposal that it should get determined by law that the recourse and damages claims by the Health Insurance Institute of Slovenia should get included in the insurance of liability, as is already determined in other areas, such as in the area of transport.
Sekundarne ključne besede: health insurance;master thesis;
URN: URN:SI:UM:
Vrsta dela (COBISS): Magistrsko delo
Komentar na gradivo: Univ. v Mariboru, Pravna fakulteta
Strani: VI, 196 str.
ID: 9156742