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Legal regulations in sickness insurance and their influence on abuse of sickness benefits
KUNCOVÁ, Věra
Abstract My Bachelor dissertation ``Legal Adjustment of Sickness Insurance and its Influence on the Abuse of Sickness Benefits{\crqq} deals with the interpretation of the legal adjustment of individual sickness insurance benefits after 1st January 2008 and with reasons which may cause the abuse of sickness insurance benefits. The main objective of my Bachelor dissertation is not only to find out these causes but also to refer to the facts which could become a basis for changes and alterations in the legal adjustment of the sickness insurance system since 1st January 2009. My work and conclusions are based on good quality research using the method of half-standardized interviews with six respondents from OSSZ (=District Social Security Administration {--} transl. remark) in Tábor and Pelhřimov, and I also involved the method of documents analysis. The research was carried out on the basis of source materials which were available in OSSZ Tábor in the periods of January and February 2007, August to December 2007 and January and February 2008 and also on the basis of statistical data for years 2005, 2006, 2007 and 2008. The gathered data and interviews results apparently show that there is a tendency to the abuse of sickness insurance benefits in the company. This fact is supported by the legal adjustment both in the area of social insurance and in the area of health insurance, and consequently in the area of the criminal law too. The research established that there might be the abuse of benefits, but on the other hand, if you compare the data showing the amount of finances invested into the sickness insurance benefits in the months of January and February of years 2005, 2006, 2007 and 2008, it is apparent that in February 2008 there is a decline in financial means invested into these benefits. We have succeeded in reduction of expenses on sickness benefits then. And the adoption of the waiting period can partly prevent from sickness benefits abusing too. In spite of that decline which has indisputably resulted from the legal adjustment valid since 1st January 2008 there are remedies that could prevent from further benefits abusing such as a consistent reform in the health service system, introduction of clear rules for checking those who are on sick leave and financial participation of employers during the sick leave of their employees. Concentration of sickness benefits payments for employees of small organizations, for self-employed individuals and for employees of organizations onto OSSZ companies (=District Social Security Administration) should make this paperwork easier and should cause the fall in expenses connected with sickness benefits payments.
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