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HEALTH INSURANCE IN UAE Dr. Febin Shamsudeen

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Page 1: Health Insurance In UAE

HEALTH INSURANCE IN

UAE

Dr. Febin Shamsudeen

Page 2: Health Insurance In UAE

Health care systems • Total Hospitals – 109• Private – 78• Managed by SEHA – 8• Managed by MoH – 16• Managed by DHCC - 5

Page 3: Health Insurance In UAE

What is Health Insurance?

• Health insurance is a type of insurance coverage that covers the cost of an insured individual's medical and surgical expenses. Depending on the type of health insurance coverage, either the insured pays costs out-of-pocket and is then reimbursed, or the insurer makes payments directly to the provider.

Page 4: Health Insurance In UAE

Emirate of Abu Dhabi

• Effective January 2006, all residents of Abu Dhabi are covered by a new comprehensive health insurance program• Costs will be shared between employers and employees• Health Authority – Abu Dhabi which is responsible for regulating the

healthcare industry and developing Abu Dhabi’s health policy.• No. of Health Insurance Company in Abu Dhabi – 29*

* http://yp.theemiratesnetwork.com/

Page 5: Health Insurance In UAE

Emirate of Dubai

• Dubai Health Authority(DHA): is responsible for regulating the healthcare industry for public and private healthcare facilities in the Emirate of Dubai• Dubai Healthcare City(DHCC): for private healthcare facilities with

Dubai Healthcare City.• No. of Health Insurance Company in Dubai : 49*

* http://yp.theemiratesnetwork.com/

Page 6: Health Insurance In UAE

Health Insurance In Abu Dhabi New Health Insurance Law• To foster an efficient and competitive health insurance industry• To protect the interests of all participants in the health insurance scheme• To ensure the optimal utilisation of health insurance premiums for the level of

benefits covered• To promote the prudential safety of all participants in the health insurance scheme• To provide appropriate health care for all participants in the health insurance

scheme• To support the private sector and encourage their active role• To provide free choice of access to patients

*

Page 7: Health Insurance In UAE

Health Insurance In Abu Dhabi Durations and terms of policiesThe insurance policies will be valid for 1 year after the date of issuance and should be renewed annually (the insured are not entitled to claim back the premium) Shifting from one policy to another is flexible provided the insured pays the difference. The policies contain basic health care services, excluded services, additional services, maximum coverage, procedure of complaints guidelines and a co-payment to be paid by the insured. The health insurance scheme shall not replace any existing obligation to procure insurance by way of Workers Compensation Coverage as per Law No. 8 for the year 1980. All employers and sponsors must still provide health insurance coverage as set within the Code of Regulations in excess to existing agreements with staff.

Page 8: Health Insurance In UAE

New Health Insurance Law in Dubai

• The new Health Insurance Law for Dubai (Insurance Law No. 11) was implemented in phases • The objective of the law is to ensure that all employees enjoy a

minimum level of health cover to protect them in the case of illness. • DMCC Free Zone was committed to this important community

objective and fully implemented this coverage requirements by end of 2014, irrespective of company size.

Page 9: Health Insurance In UAE

New Health Insurance Law in Dubai • All insured members will have benefits that meet the minimum

standards.

• Essential Benefits Plan-DHA wants to ensure that the most vulnerable workers are protected. Because of this insurers will only be able to make reasonably small profits from the Essential Benefits Plan. Accordingly, only those insurance companies who can provide cover on a cost effective basis, who can handle volume business and can demonstrate operational effectiveness and high levels of customer service will be able to sell the Essential Benefits Plan to the segment of the Resident population earning 4,000 AED or less per month.

Page 10: Health Insurance In UAE

• The Insurance Authority (IA) was established under the Federal Law No. 6 of 2007 with a legal

personality and financial and administrative independence.

• The Federal Law No. 6, which came into force as from 28.08.2007, entrusted the Authority to regulate and supervise the insurance sector in the United Arab Emirates in order to ensure the provision of a favorable climate for its development and promote the role of the insurance industry to indemnify persons, property and liabilities against risks to ultimately protect the national economy; accumulate and grow national savings and invest them to support the economic development in the UAE; encourage fair and effective competition; provide the best insurance services with appropriate coverage at affordable rates, and achieve job Emiratization in the UAE insurance market.

• The Board of Directors of the IA was formed under the UAE Cabinet .The Board is chaired H.E. Humaid Ali bin Butti Al Muhairi, H.E. Mariam Butti Al Suwaidi, by His Excellency Sultan bin Saeed Al Mansouri, Minister of Economy. The membership of the Board include H.E. Mariam Mohammad Amiri, H.E. Hamad Harith Al Medfaa, Mr. Hamad Saif Al Mansouri, and Mr. Ahmed Ajlan Qubaisi.

*http://www.ia.gov.ae

Page 11: Health Insurance In UAE

• The Executive Committee of the IA Board of Directors is concerned with the examination and review of all topics or proposed amendments to the Insurance Authority Law, the regulations or decisions issued pursuant thereto, or draft decisions relating to the work of the IA and formulate the advice and opinion thereon before submission to the Board of Directors. The Committee may form working groups, if necessary, determine their duties and follow up their work. The Committee shall submit the minutes of its meetings together with its recommendations and proposals to the Board of Directors or the Chairman as the case may be, in addition performing any tasks assigned to the Committee by the Board of Directors or the Chairman within the limits of the prescribed powers

*http://www.ia.gov.ae

Page 12: Health Insurance In UAE

Protecting the rights of the insured and the beneficiaries of the insurance operations and monitoring solvency of the companies to avail satisfactory insurance coverage in order to protect these rights.

Enhancing performance and efficiency of the insurance companies and binding them to observe the profession's code and rule of conduct to enhance their capabilities to render the beneficiaries of the insurance the best services and attain constructive competition.

Providing efficient and qualified human resources to carry out insurance operations including establishment of an institute for the purpose in cooperation and collaboration with Emirates Insurance Association (EIA) according to the prevailing legislations.

Proposing programs and plans to develop the insurance sector in all aspects and enhancing insurance awareness, preparing studies and researches relevant to the insurance operations and disseminating the same.

DUTIES

*http://www.ia.gov.ae

Page 13: Health Insurance In UAE

Consolidating cooperation and integration ties with the authorities

organizing insurance sector at both the Arab world and International levels.

Receiving applications to establish, open branches and representative offices for insurance and re-insurance companies, insurance brokers and the professions related thereto and issuing them the necessary licenses.

Identifying the risks which shall be compulsorily insured. Determining unified tariffs of certain types of insurances and of those

one enlisted there under in cases the public interest would require.

DUTIES

Page 14: Health Insurance In UAE

Thank You