أحكام المطالبات و الاستثناءات في تغطيات التأمين الصحي التعاوني

Abstract EN

This research deals with studying the rules of exceptions in cooperative health insurance coverage, and the corresponding practices of policy holders and their false claims, It aims to evaluate the applied reality of Islamic insurance, as it is a type of cooperation on righteousness and piety, So, that it may reveal the real sense of cooperation for righteousness and piety, and for not transforming the practice to cooperation fur sinfulness and transgresses.

The research has revealed the characteristics and conditions of cooperative health insurance to concluded that the permissible exceptions are those that do not contradict with those characteristics and conditions, Consequently, cooperative insurance companies should not violate the terms of the conditions in the exceptions, and in practice, they resort to acquiescence and arbitrariness in setting new exceptions after )entering in( the contract; and this behavior may not be offset by some policyholders’ behavior by resorting to fake claims except in cases of access to the right that they were denied the policy holder because of these arbitrary exceptions.