The Health Insurance Commission intends to actively prosecute companies that violate the Health Insurance Law, said Acting Senior Crown Counsel Trevor Ward of the Cayman Islands Legal Department last week.
In the past two weeks, the first case concerning failure to effect and maintain health insurance was heard in Grand Court, resulting in convictions for Air Tech Corporation Ltd. and Godfrey Bowen, an individual in authority with the company.
Last week, charges were also brought to Summary Court against Robert Campbell and Campbell’s Auto Repair & Sales for failure to effect and maintain a standard contract for health.
HIC Chair Suzanne Bothwell told the attendees of the Cayman Islands Insurance Association’s annual health insurance seminar that the court actions were a result of a position taken by the HIC Board a few years ago.
‘One of the primary challenges faced by the HIC was the public perception that the health insurance legislation had no bite,’ she said. ‘This resulted in the flouting of the legislative requirements to take out and maintain health insurance for employees and their families, and also the belief that there was no need to adhere to the warnings of the superintendent of Health Insurance.’
As result of that perception, the HIC took the position to actively pursue cases through the criminal justice system ‘to remove the myth that breaching health insurance rules did not have serious repercussions,’ Mrs. Bothwell said.
Mr. Ward noted that there have been challenges to certain sections of the law in the cases brought to court, but that the law has withstood those challenges.
The law makes offences a matter of absolute liability, which means there can be no excuses for failure to comply to the law, Mr. Ward explained.
‘It’s not a defence to say I didn’t know,’ he said. ‘It’s not a defence to say that Mrs. ‘X’ was responsible for putting those things in place. There is absolute responsibility for the employer to be in strict compliance of the [law].’
Mr. Ward also explained that the definition of employer is much broader than many people realise.
‘An employer includes any agent, representative or manager who is placed in authority over an employee,’ he said.
One of the ways the Health Insurance Commission intends to find employers who are not in compliance with the law are through random inspections by health insurance inspectors.
Mr. Ward said employers must comply with an HIC request to see records.
‘Some businesses have tried to say ‘we’re busy; we can’t deal with it now’,’ he said.
But employers who refuse to comply with an information request from a health insurance inspector are subject to a fine of $10,000 on summary conviction.
Mr. Ward said the HIC tries to work with companies that are not complaint with the law to seek a resolution.
‘They give an employer every opportunity to comply,’ he said. ‘They are not gung-ho to take someone to court.’
If an employer doesn’t have insurance in place for employees, the HIC wants to know what is being done to rectify the situation, Mr. Ward said.
‘No one can say with the Health Insurance Commission that they haven’t had a reasonable opportunity to put their house in order.’
CIIA director Trevor Stewart, who acted as moderator of the seminar, also had a warning for employers: ‘[The Health Insurance Law] is a law that can bite you,’ he said.