Health Insurance Commission performing

Please allow me the opportunity to respond to the editorial titled Laws need enforcing, posted on www.caycompass.com on Wednesday, 19 August, 2009.

The editorial improperly reported on the enforcement efforts and the information on the number of complaints/queries received by the Health Insurance Commission, stating that ‘in spite of the thousands of complaints only six cases have made their way to the court since the Health Insurance Law was passed 12 years ago.’

Please be informed that the Health Insurance Commission was established by the Health Insurance Commission Law, 2003 and the Health Insurance Commission Board held its first meeting on 4 March, 2004. The Inspectorate team of the Commission was not implemented until 2005, four years ago. In the one-year period, 1 July, 2008, to 30 June, 2009, the Commission received 1,181 complaints /queries. As at 30 June, 2009, there were 205 unresolved complaints/queries, of which 47.8 per cent (98) were received in May and June 2009.

The Commission has been resolving disputes at a rate of approximately 90 per cent of all complaints/queries received over the past four years. Sections 22 and 23 of the Health Insurance Law (2005 Revision) provides the Commission with the authority to address complaints, resolve disputes and impose fines, if necessary, to enforce the law. Only in exceptional cases is there a need to resort to the courts. Currently, there are six pending court matters. Therefore, it must be noted that the number of cases in court is not a valid indicator as to whether the Commission is taking the necessary action to enforce the health insurance legislation.

The Commission has taken all measures to enforce the health insurance legislation and continues to do so, despite limited resources.

Mervyn Conolly – Superintendent of Health Insurance

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