DoH issues fines for health insurance violations

The Department of Health Abu Dhabi recently issued a decision concerning the schedule of violations and administrative fines for health insurance. This decision replaces Schedule No. (4) as part of the executive regulations of Law (23) of 2005 for health insurance in the emirate of Abu Dhabi.

A statement on the Abu Dhabi Media Office Twitter page said that the violations and administrative fines imposed on companies and employers reflected the government’s wishes to provide integrated and continuous healthcare services to all segments of the community and to secure the rights of all parties.

The decision includes 43 violations each amounting to fines ranging from AED100 to AED20,000. Among the violations, DoH has specifically mentioned that an insurance company or third party administrator (TPA) that fails to pay or delays payment for an amount owed for healthcare services as stated in the contract signed by the insurance company or TPA with the healthcare provider will receive a fine of AED20,000. Also, individuals who use a health insurance policy that is not in their name will incur a fine of AED5000. In addition, an employer that refuses to cover the cost of health services or medical services for emergency cases for employees who are supposed to be under the employer’s health insurance but did not provide them with valid cover will be fined AED1000.