Some private health insurers not fully compliant with Health Insurance Act 


The Health Insurance Authority (HIA) found some instances of non-compliance amongst private health insurers during 2020.

A report published today found that personal health insurers were generally compliant with their obligations under the Risk Equalisation Scheme. Nonetheless, inspection findings resulted in a refund to the Risk Equalisation Fund of €262,000.

The HIA inspected registered medical health insurance corporations in Ireland to make sure their compliance with commitments under the Risk Equalisation Fund, which has an annual value of over €800m.

The three medical health insurance corporations inspected were VHI Insurance DAC’s, Elips Versicherungen AG and Irish Life Health DAC’s. While they were largely compliant with the Health Insurance Act, the HIA identified areas where some insurers applications of policies weren’t fully compliant with regulations. 

These findings of the inspections were sent to the relevant insurers in January 2022. Recommendations were made by the HIA to the relevant insurers following the inspection results. 

A resolution is being established for 2 of the findings, and a refund of €262,000 was made to the Risk Equalisation Fund. 

Regarding the third finding, the HIA is engaging directly with the registered insurers, and a selected timeline for resolution has been established.

The quarterly report from the HIA shows that the medical health insurance market in Ireland continued to grow in the primary quarter of 2022.

There was a 1% increase within the proportion of the population with private medical health insurance for the reason that end of 2021. 

47.5% of the population now hold private medical health insurance. 

The variety of medical health insurance plans available has grown to 325. The typical adult premium is €1,450 at the tip of the primary quarter.

The primary quarter has also seen a 1% decline in prices across like-for-like plans.

Speaking in regards to the Inspection Report Laura Brien, CEO, HIA said: “The report reflects the importance of the Authority’s role in overseeing the health insurers and ensuring that they achieve high levels of compliance with the broad range of their obligations. 

“It also highlights the importance of the Authority’s role in managing the Risk Equalisation Fund, and oversight of other key features of medical health insurance regulation. 

“The Risk Equalisation Fund supports the policy of community ration that ensures all consumers no matter age, gender or health status pay the identical price for a similar insurance plan,” she added. 


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