Health insurance trial starts

Trial began in Summary Court on Monday for an employer accused of failing to effect and maintain a standard health insurance contract for an employee.

The defendants are the company Cayman Elite Ltd. and the individual Wendel Wendel.

The first witness was Mr. Mervyn Conolly, Superintendent of Health Insurance and chief executive officer of the Health Insurance Commission.

He explained the process by which complaints are received and how letters are then sent to the employer complained about.

A person who wishes to complain is required to fill out a complaint form, which must then be signed and witnessed, he explained.

In this case, he confirmed receiving a complaint from an employee in October 2004. After efforts to ascertain the legitimacy of the complaint, letters were sent to Mr. Wendel in February and April 2005.

No response was received to either letter.

Mr. Conolly explained that it is an employer’s duty to have a standard health insurance contract for each of his employees and any child and unemployed spouse of an employee. The employer is responsible for half of the monthly premium.

The law also provides for situations where an employer neglects to effect a contract of health insurance coverage or does not comply with the law regarding payment of premiums.

In such cases, Mr. Conolly indicated, if a person has lost the benefit of health insurance, he is entitled to recover loss or damages from the employer.

In the matter before the court, the complainant was claiming compensation for insurance he said he obtained on his own plus $224.78 in uninsured medical expenses.

Cross-examined by Defence Attorney Keith Collins, Mr. Conolly said he understood that Mr. Wendel’s other employees were covered.

Mr. Collins then asked him about situations in which an employer would not be liable for providing insurance.

Mr. Conolly agreed that a previously unemployed person who was covered by his spouse’s insurance could elect to continue coverage through the spouse’s employer or be covered by his own employer.

Mr. Conolly also said that, to the best of his knowledge, the complainant did not say that he had told Mr. Wendell he was covered through his wife.

If he had, Mr. Conolly said he would want to know why the complaint was brought. If he had facts such as those put to him by Mr. Collins hypothetically, ‘we would not bring the case,’ Mr. Conolly said.

Crown Counsel Trevor Ward also called Mr. Wesley Gibson, an inspector with the Health Insurance Commission. He told the court about visiting Mr. Wendel at his office in connection with the complaint.

He also confirmed that Elite Cayman Ltd was a registered company with a valid trade and business licence.

Questioned by Mr. Collins, he said he knew that the complainant’s wife was working on the island, but he did not ascertain whom she worked with.

Mr. Gibson indicated that the complainant himself was off-island because of work-related matters.

Mr. Collins said he could not agree to having the complainant’s statement read; he wanted the man to give evidence in person so that he could be cross-examined.

The earliest date that could be agreed on for the trial to continue was 23 October and Magistrate Grace Donalds adjourned the matter until then.

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