Cayman’s Health Insurance Commission has received 1,384 complaints since last year.
Superintendent of Health Insurance Mervyn Conolly gave the statistic Saturday during the Health Care 20/20 conference at The Ritz-Carlton, Grand Cayman.
Mr. Conolly said more than 70 per cent of the complaints were made by insured people.
“The complaints are mostly against employers,” he said.
Two common complaints against employers are that they fail or refuse to take out insurance for an employee, or they take out insurance and allow it to lapse, often continuing to deduct premiums from an employee’s salary nonetheless. He said that in many cases employees would not even know their coverage has lapsed until they try to use it for medical treatment.
The Health Insurance Commission has three health insurance inspectors and one assistant health insurance inspector. Mr. Conolly said that 83 per cent of 1,384 complaints had been resolved and 10 were pursued in the courts.
“We have no control over the number of complaints, but we look at each one of them,” he said. “We try to have the complaints resolved in 10 working days, but some take months.”
Mr. Conolly said that people ask why more cases aren’t taken to court, but that trying to get resolution through the court is very difficult and can take a year or more.
“There are a couple of cases pending more than two years,” he said.
Instead of pursuing many cases through the courts, the Health Insurance Commission takes a different approach.
“What we want is resolutions; we want to get complaints resolved.”
The other complaints are mostly against approved insurers, he said.
Mr. Conolly said that proposed amendments to the Health Insurance Law could have an impact on compliance with the law.
Proposed amendments would provide for fines to be levied administratively by the Health Insurance Commission and would increase the fines and penalties for noncompliance. He said that the current fines are so small that there is almost an incentive for employers not to take out insurance on their employees because even if they are fined, the fine is less than the cost of providing health insurance.
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