ÃËÎÑÑÀÐÈÉ

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òåðìèíîâ, óïîòðåáëÿåìûõ â êîíòåêñòå äîáðîâîëüíîãî ìåäèöèíñêîãî ñòðàõîâàíèÿ (GLOSSARY of terms used in the context of voluntary medical insurance)

Note: English translations include some refinements not included in the Russian original text

ÀÊÒÓÀÐÍÛÉ ÐÀÑ×ÅÒ - ìàòåìàòè÷åñêèå è ñòàòèñòè÷åñêèå èññëåäîâàíèÿ ìåõàíèçìîâ îáðàçîâàíèÿ è ðàñõîäîâàíèÿ ñòðàõîâûõ ðåçåðâîâ, èìåþùèå êîíå÷íîé öåëüþ ôîðìèðîâàíèå òàðèôîâ ïî âèäàì ñòðàõîâàíèÿ. Ìåòîäîëîãèÿ à.ð. îñíîâàíà íà òåîðèè âåðîÿòíîñòè, òåîðèè áîëüøèõ ÷èñåë, èñïîëüçîâàíèè ìàòåìàòè÷åñêîé ñòàòèñòèêè, äåìîãðàôè÷åñêèõ èññëåäîâàíèé. Ïðèìåíèòåëüíî ê ÄÌÑ à.ð. ðàññìàòðèâàåò ïîêàçàòåëè ïîòðåáëåíèÿ ïðåäóñìîòðåííîé ÑÏ ìåäèöèíñêîé ïîìîùè, öåíû íà ìåäèöèíñêèå óñëóãè êàê ñîñòàâíûå ñòðàõîâûõ òàðèôîâ. = ACTUARIAL ACCOUNTING - mathematical and statistical investigation of forecasts, risk costs, and adequacy of financial reserves, together with the processes of premium-setting and appraising returns from new types of insurance product. Actuarial accounting is based on statistical theory, demographic analysis, and time-series calculations.

ÀÓÄÈÒ - íåçàâèñèìàÿ ïðîâåðêà ôèíàíñîâî-õîçÿéñòâåííîé äåÿòåëüíîñòè êîìïàíèé ñ öåëüþ îïðåäåëåíèÿ åå äåéñòâèòåëüíîãî ôèíàíñîâîãî ïîëîæåíèÿ. À. ïðîâîäèòñÿ àóäèòîðîì - ôèçè÷åñêèì èëè þðèäè÷åñêèì ëèöîì, èìåþùèì ëèöåíçèþ íà ýòîò âèä äåÿòåëüíîñòè è íåîáõîäèìûå ïîëíîìî÷èÿ. = AUDIT - independent inspection of companies' financial records and accounts for the purpose of confirming the reported financial position. Audits are carried out by an auditor - a physical or legal entity licensed and duly authorised to undertake this type of activity.

ÁÐÎÊÅÐ ÑÒÐÀÕÎÂÎÉ - êîìïàíèÿ èëè ôèçè÷åñêîå ëèöî, ïðåäñòàâëÿþùåå èíòåðåñ ñòðàõîâàòåëÿ â ïîäáîðå ñòðàõîâùèêà è îïòèìàëüíîãî âèäà ñòðàõîâàíèÿ, çàùèùàþùåãî èíòåðåñ ñòðàõîâàòåëÿ. = INSURANCE BROKER - a company or physical entity representing the interests of the insured with regard to selecting an insurer and optimum form of insurance to protect the insured's interests.

ÂÎÇÍÀÃÐÀÆÄÅÍÈÅ ÊÎÌÈÑÑÈÎÍÍÎÅ - îïëàòà òðóäà àãåíòà çà ðàáîòó ïî çàêëþ÷åíèþ äîãîâîðîâ ñòðàõîâàíèÿ è îáåñïå÷åíèþ ïîñòóïëåíèÿ ñòðàõîâûõ ïëàòåæåé. Â.ê. äîëæíî ó÷èòûâàòüñÿ ïðè ðàñ÷åòå ñòðàõîâîãî òàðèôà. Êàê ïðàâèëî, âûðàæàåòñÿ â ïðîöåíòå îò ñòîèìîñòè äîãîâîðà. = COMMISSION - payment by an insurer for an agent's work in selling insurance contracts. Commission is usually calculated as a percentage of the premium, and allowance is made in pricing, for levels of commission and other selling costs.

ÄÂÎÉÍÎÅ ÑÒÐÀÕÎÂÀÍÈÅ - ïîðîê ñòðàõîâîé òåõíîëîãèè, çàêëþ÷àþùèéñÿ â ñòðàõîâàíèè äàííîãî èíòåðåñà, óæå îáåñïå÷åííîãî ñòðàõîâûì äîãîâîðîì, âî âòîðîé ðàç, íà òî æå âðåìÿ è îò òîé æå îïàñíîñòè. Ïðèìåíèòåëüíî ê ÄÌÑ ä.ñ. âñòðå÷àåòñÿ êàê âêëþ÷åíèå â ñòðàõîâîé òàðèô ñòîèìîñòè ìåäóñëóã, îïëàòà êîòîðûõ îñóùåñòâëÿåòñÿ ÎÌÑ. = DOUBLE INSURANCE - coverage, usually unintended, by more than one insurance policy, of a given risk, for the same period. Double insurance may be found when voluntary insurance covers the cost of the same medical services already reimbursible by compulsory medical insurance.

ÄÎÑÒÐÀÕÎÂÀÍÈÅ - ïðèíÿòèå ñòðàõîâùèêîì íà ñåáÿ ÷àñòè ðèñêà, äðóãàÿ ÷àñòü êîòîðîãî óæå ïîêðûòà äðóãèì äîãîâîðîì ñòðàõîâàíèÿ. ÄÌÑ ìîæåò ðàññìàòðèâàòüñÿ êàê ä. ê ãàðàíòèðîâàííûì îáúåìàì ìåäèöèíñêîé ïîìîùè. = SUPPLEMENTARY INSURANCE - the insurer accepts a portion of the risk, the other portion of which is covered by another insurance agreement. VMI may be regarded as insurance supplementary to the amounts guaranteed by medical assistance.

ÇÀÙÈÒÀ ÑÒÐÀÕÎÂÀß (ïðèìåíèòåëüíî ê ÄÌÑ) - ñîâîêóïíîñòü îòíîøåíèé, íàïðàâëåííûõ íà îáåñïå÷åíèå îáÿçàòåëüñòâ â ðàìêàõ òðåáîâàíèé ñòðàõîâîãî ïðîäóêòà. = INSURANCE PROTECTION (with reference to VMI) - the total range of coverage guarantees contracted by an insurer within the insurance product offered.

ÊÂÎÒÀ (â ÄÌÑ) - îôîðìëåííîå äîãîâîðîì ïðåäåëüíîå êîëè÷åñòâî çàñòðàõîâàííûõ ïî äàííîìó âèäó ÄÌÑ, êîòîðîå áåðåò íà îáñëóæèâàíèå ìåäèöèíñêàÿ áàçà. = QUOTA (in VMI) - the maximum number of insured to be serviced by the medical (provider-) base under the type of VMI in question, formalised by an agreement.

ÊÓÌÓËßÖÈß (â ñòðàõîâàíèè) - ñîâîêóïíîñòü ðèñêîâ, ïðè êîòîðîé íåñêîëüêî îáúåêòîâ ñòðàõîâàíèÿ ìîãóò áûòü çàòðîíóòû îäíèì è òåì æå ñòðàõîâûì ñîáûòèåì. Ïðèìåíèòåëüíî ê ÄÌÑ ìîæíî ãîâîðèòü î ê. ïðè ýïèäåìè÷åñêîì ðàñïðîñòðàíåíèè çàáîëåâàíèé, ïðèðîäíûõ àíîìàëèÿõ,àâàðèÿõ, êàòàñòðîôàõ è ò.ï., ïðèâîäÿùèõ ê ðîñòó ïîòðåáëåíèÿ ìåäèöèíñêîé ïîìîùè, ïðåäóñìîòðåííîé ÑÏ. = CUMULATION (in insurance) - the aggregation of risks to which a set of insured persons may be exposed by one and the same insured event. In VMI , examples are epidemics, natural hazards, accidents, catastrophes etc., leading to a surge of claims against the insurer.

ÌÅÄÈÖÈÍÑÊÀß ÁÀÇÀ ÄÌÑ - ëå÷åáíî-ïðîôèëàêòè÷åñêèå ó÷ðåæäåíèÿ, îñóùåñòâëÿþùèå îáñëóæèâàíèå çàñòðàõîâàííûõ â ðàìêàõ äîãîâîðà î ñîâìåñòíîé äåÿòåëüíîñòè ñ ÌÑÎ ïî ÄÌÑ. = VMI MEDICAL BASE - treatment and prevention institutions servicing insured population, in the context of a VMI joint activity agreement with the Ministry of Social Security.

ÌÅÍÅÄÆÌÅÍÒ ÐÈÑÊÀ (òî æå óïðàâëåíèå ðèñêîì) - êîìïëåêñ ìåðîïðèÿòèé, íàïðàâëåííûõ íà ñíèæåíèå âåðîÿòíîñòè íàñòóïëåíèÿ ñòðàõîâîãî ñëó÷àÿ. Ì.ð. îðãàíèçóåòñÿ ñòðàõîâùèêîì â öåëÿõ ñíèæåíèÿ çàòðàò ïî ñòðàõîâîìó âîçìåùåíèþ.  ÄÌÑ ì.ð. çàêëþ÷àåòñÿ â ïðîâåäåíèè ïðîôèëàêòè÷åñêèõ ìåðîïðèÿòèé, íàïðàâëåííûõ íà ñíèæåíèå çàáîëåâàåìîñòè. = RISK MANAGEMENT - a range of measures designed to reduce the likelihood of an insured event occurring. Risk management is organised by the insurer for the purpose of reducing avoidable claims incidence. In VMI, risk management includes preventative measures intended to reduce the number of cases of illness.

ÍÎÓ-ÕÀÓ - ìåòîäè÷åñêèå è òåõíîëîãè÷åñêèå ðàçðàáîòêè, îïûò, ñîñòàâëÿþùèå ïðîèçâîäñòâåííûé ñåêðåò, ïîçâîëÿþùèå ýôôåêòèâíî ðåøàòü ïîñòàâëåííûå çàäà÷è.  ÄÌÑ í.-õ. ïðåäñòàâëÿþò ñòðàõîâûå ïðîäóêòû, êîòîðûå ÿâëÿþòñÿ ñîáñòâåííîñòüþ ðàçðàáîò÷èêîâ. Ïðàâî èñïîëüçîâàíèÿ í.-õ. ìîæåò ÿâëÿòüñÿ ïðåäìåòîì êóïëè-ïðîäàæè. = KNOW-HOW - methodical and technological development and experience of commercial value, giving efficient business solutions. In VMI, know-how can arise from proprietory experience of particular insurance products. Entitlement to utilise know-how may be bought and sold.

ÎÁßÇÀÒÅËÜÍÎÅ ÑÒÐÀÕÎÂÀÍÈÅ - îäíà èç ôîðì ñòðàõîâàíèÿ, ïðè êîòîðîé ñòðàõîâûå îòíîøåíèÿ âîçíèêàþò â ñèëó çàêîíà. Î.ñ. ìåäèöèíñêîå ÿâëÿåòñÿ ðàñïðîñòðàíåííîé ôîðìîé ôèíàíñèðîâàíèÿ çäðàâîîõðàíåíèÿ â ðàìêàõ ãàðàíòèðîâàííûõ îáúåìîâ ìåäèöèíñêîé ïîìîùè.  Ðîññèè ðåãëàìåíòèðóåòñÿ çàêîíîì, ïðèíÿòûì â 1992 ãîäó. = COMPULSORY INSURANCE - a form of insurance in which cover results from legal provisions. Compulsory medical insurance is a widespread method of financing public health in the context of guaranteed amounts of medical assistance. In Russia it is regulated by a law passed in 1992.

ÎÒÂÅÒÑÒÂÅÍÍÎÑÒÜ ËÈÌÈÒÈÐÎÂÀÍÍÀß - ñóììà, â ïðåäåëàõ êîòîðîé ñòðàõîâàÿ îðãàíèçàöèÿ ïðèíèìàåò íà ñåáÿ îòâåòñòâåííîñòü ïî äàííîìó âèäó ñòðàõîâàíèÿ. ßâëÿåòñÿ ïðåäìåòîì ñòðàõîâîãî äîãîâîðà. = LIMITED LIABILITY - the sum within the limits of which an insurance organisation undertakes liability under the type of insurance in question. It is the subject of an insurance contract.

ÏÅÐÅÑÒÐÀÕÎÂÀÍÈÅ - ïåðåäà÷à íà ñîãëàñîâàííûõ óñëîâèÿõ ñòðàõîâîé îòâåòñòâåííîñòè äðóãèì ñòðàõîâùèêàì. = REINSURANCE - transfer of insurance liability to other insurers on agreed terms.

ÏÎËÅ ÑÒÐÀÕÎÂÎÅ - ìàêñèìàëüíîå êîëè÷åñòâî îáúåêòîâ, êîòîðîå ìîæåò áûòü îõâà÷åíî äàííûì âèäîì ñòðàõîâàíèÿ. Ðàçëè÷àþò çàíÿòîå ñ.ï. (îõâà÷åííîå ñòðàõîâàíèåì) è íåçàíÿòîå (íå îõâà÷åííîå ñòðàõîâàíèåì). = INSURANCE FIELD - the scope of coverage for a given type of insurance. There is a distinction between an occupied insurance field (in which insurance is offered) and an unoccupied insurance field.

ÏÎÐÒÔÅËÜ ÑÒÐÀÕÎÂÎÉ - îáùèé îáúåì ñòðàõîâûõ îáÿçàòåëüñòâ ñòðàõîâîé êîìïàíèè. Ìîæåò õàðàêòåðèçîâàòüñÿ ïî ÷èñëó çàñòðàõîâàííûõ îáúåêòîâ, ÷èñëó äîãîâîðîâ ñòðàõîâàíèÿ, ðàçìåðó îáùåé ñòðàõîâîé ñóììû, âèäàì ñòðàõîâàíèÿ. = INSURANCE PORTFOLIO - the total volume of an insurance company's insurance obligations. It may be described by the number of persons covered, the number of insurance contracts, the total sum insured, or by types of insurance.

ÏÐÀÂÈËÀ ÑÒÐÀÕÎÂÀÍÈß (òî æå - ïîëèñíûå îáÿçàòåëüñòâà) - àêò íîðìàòèâíî-òåõíîëîãè÷åñêîãî õàðàêòåðà, îïðåäåëÿþùèé óñëîâèÿ äîáðîâîëüíîãî ñòðàõîâàíèÿ. = INSURANCE RULES (the same as policy obligations) - a document with legal character, defining the terms and conditions of voluntary insurance.

ÐÅÇÅÐÂÛ ÑÒÐÀÕÎÂÛÅ - ôîíäû, îáðàçóåìûå ñòðàõîâûìè îðãàíèçàöèÿìè, äëÿ îáåñïå÷åíèÿ ãàðàíòèé, ïðåäóñìîòðåííûõ óñëîâèÿìè äîãîâîðîâ ñòðàõîâàíèÿ. = INSURANCE RESERVES - funds formed by insurance organisations to back the guarantees they offer in insurance contracts.

ÐÈÑÊ ÑÒÐÀÕÎÂÎÉ - âåðîÿòíîå ñîáûòèå èëè ñîâîêóïíîñòü ñîáûòèé, íà ñëó÷àé íàñòóïëåíèÿ êîòîðîãî ïðîâîäèòñÿ ñòðàõîâàíèå. = INSURANCE RISK - a specified contingency or aggregate of contingencies which are insured against.

ÑÒÐÀÕÎÂÎÉ ÏÐÎÄÓÊÒ - êîíå÷íûé ðåçóëüòàò ðàçðàáîòêè êîíêðåòíîãî âèäà ñòðàõîâàíèÿ, ïðåäñòàâëÿþùèé èç ñåáÿ íàáîð äîêóìåíòîâ, ïîçâîëÿþùèé çàïóñòèòü è âåñòè äàííûé âèä ñòðàõîâàíèÿ. = INSURANCE PRODUCT - the public offering resulting from development of a specific type of insurance, embodied in a set of documents facilitating the starting up and maintenance of the type of insurance in question.

ÑÒÐÀÕÎÂÎÉ ÍÀÄÇÎÐ - êîíòðîëü çà äåÿòåëüíîñòüþ ñòðàõîâûõ ó÷ðåæäåíèé, îñóùåñòâëÿåìûé ñïåöèàëüíî óïîëíîìî÷åííûìè ãîñóäàðñòâåííûìè îðãàíàìè. = INSURANCE INSPECTION - monitoring of insurance institutions' activities, finances and solvency, undertaken by specially authorised State bodies.

ÑÒÐÀÕÎÂÀß ÒÅÕÍÎËÎÃÈß - ñîâîêóïíîñòü ìåòîäîâ, ïðèåìîâ è ðåñóðñîâ, êîòîðûå èñïîëüçóåò ñòðàõîâùèê. = INSURANCE TECHNOLOGY - the sum total of methods, devices and resources used by the insurer.

ÑÒÐÀÕÎÂÙÈÊ - þðèäè÷åñêîå ëèöî, ïðîâîäÿùåå ñòðàõîâàíèå è áåðóùåå íà ñåáÿ îáÿçàòåëüñòâî âîçìåùåíèÿ óùåðáà ïî ñòðàõîâûì ñëó÷àÿì. = INSURER - a legal entity undertaking insurance, the obligation to indemnify against the cost of future uncertain risks.

ÑÒÐÀÕÎÂÀÒÅËÜ - ôèçè÷åñêîå èëè þðèäè÷åñêîå ëèöî, çàêëþ÷àþùåå ñî ñòðàõîâùèêîì äîãîâîð ñòðàõîâàíèÿ. = THE INSURED - a physical or legal entity concluding an insurance agreement with an insurer.

ÑÒÐÀÕÎÂÎÉ ÑËÓ×ÀÉ - ñâåðøèâøååñÿ ñòðàõîâîå ñîáûòèå. = INSURED INCIDENT - an insured event which has taken place.

ÑÒÐÀÕÎÂÎÅ ÑÎÁÛÒÈÅ - îáñòîÿòåëüñòâî, îïðåäåëåííîå äîãîâîðîì ñòðàõîâàíèÿ (â äîáðîâîëüíîì ñòðàõîâàíèè) èëè çàêîíîì (â îáÿçàòåëüíîì ñòðàõîâàíèè) êàê ñîáûòèå, ïî êîòîðîìó ñòðàõîâùèê îáÿçàí èñïîëíÿòü ñâîè îáÿçàòåëüñòâà ïî ñòðàõîâîìó âîçìåùåíèþ. = INSURED EVENT - a circumstance specified by the insurance agreement (in voluntary insurance) or by law (in compulsory insurance) as an event concerning which the insurer is obliged to fulfil insurance compensation obligations.

ÔÐÀÍØÈÇÀ - ïðåäóñìîòðåííîå óñëîâèÿìè ñòðàõîâàíèÿ îñâîáîæäåíèå ñòðàõîâùèêà îò âîçìåùåíèÿ óáûòêîâ, íå ïðåâûøàþùèõ îïðåäåëåííûé ðàçìåð. Â ÑØÀ ô. èñïîëüçóåòñÿ â ìåäèêàìåíòîçíîì ñòðàõîâàíèè: ñòðàõîâàÿ êîìïàíèÿ âîçìåùàåò çàòðàòû íà ïðèîáðåòåíèå ëåêàðñòâ íà ñóììó, ïðåâûøàþùóþ 100 äîëëàðîâ. = FRANCHISE - (not UK English usage:) terms of an insurance contract which exempt the insurer from compensation of losses not exceeding a specified amount. In the USA 'deductibles' are used in insurance for pharmaceutical prescriptions: the insurance company reimburses expenses of obtaining medicines where the sum exceeds, say,$100. (UK usage: business concession yielding part of franchisee's revenue to franchisor whose 'know-how' and/or name is franchised)