Your Risk Management Advisors

11th May 2017

DHA- NO.1 HEALTH CARE PROVIDER IN THE WORLD

Dr. Haider Al Yousuf, Dr Amin Hussain Al Amiri, Prof. Muthanna G. Abdul Razzaq and senior officials from the DHA attending the 1st AUE International Forum on Insurance, Hospital & Healthcare Management.
Image Credit:Organisers

Dubai: Health care is a major priority in the UAE and the Dubai Health Authority (DHA) is determined to become the world leader in providing the finest health care and health insurance system, according to a senior official of the authority.

Speaking during the first American University in the Emirates (AUE) International Forum on Insurance, Hospital & Healthcare Management, Dr Haider Al Yousuf, director of Public Health Funding at the DHA, said: “This is something that we strongly believe in and we have the wise leadership and vision to actually achieve our goals.

“Prior to the mandatory Dubai Health Insurance Law, which came into effect in January 2014, more than half the population in the emirate did not have insurance.

“The Government of Dubai decided to use health finance as a way of restructuring the emirate and today, as we have completed the whole roll-out of the insurance system with all nationalities covered, including expatriates, we have over 4.5 million people enjoying the whole benefits of health insurance in Dubai,” he added.

“For the first time, all information is standardised and is going through one single database.”

According to SAS (Statistical Analysis System), Dubai has the cleanest health data system in the world. Last year, more than 20 million transactions went through the DHA’s health e-claim system and this represents 63 million services provided to the insured population in Dubai, said Al Yousuf.

“So we are delighted to be able to work with a university like the AUE to reap the benefit from your research capabilities to actually use the data to help advance forward clinical guides and use this tool for improving the health care of the population in Dubai.

“We are here to collaborate with educational institutes and would like to see a whole pipeline of students coming through and we are eager to have them on board,” he concluded.

Earlier, Dr Ameen Hussain Al Amiri, assistant undersecretary of Public Health Policy and Licensing Sector in the UAE Ministry of Health, outlined the progress made by the DHA and its vision for the future.

Dr Mohammad Abdul Qader Al Reda, director of Health Data and Information Analysis at DHA, said: “We look forward to your investment paying off as we have to look at people as human assets.

“The culture of health insurance is still new in our region. We are still enjoying learning from countries who are still ahead of us like the US, France and Germany.

“We still have a long way to go. To achieve our goals, we need the right people — the right doctors, the right nurses, the right physiotherapists, the right administrators etc. But we have the data and capabilities to do it.”

Prof Muthanna G. Abdul Razzaq, president and CEO of the AUE, thanked the representatives from the DHA for their willingness to collaborate with the university and its students.

“As I keep pointing out, we want to graduate leaders and not managers, and collaborations like these will go a long way to help shape the vision and determination of an individual,” he said.

“At the AUE, we believe that ‘nothing is impossible’, and I keep encouraging our students and faculty to think outside the box and to help create more ideas and get better results.”

6th May 2017

UAE AUTO INSURANCE NOW COSTS 15% MORE

Traffic on Shaikh Zayed Road in Dubai. The UAE Insurance Authority revised the unified auto insurance regulations with effect from January this year, hiking premiums for both third party and comprehensive insurance for all categories of vehicles.
Image Credit:A K Kallouche/Gulf News

Dubai: Motorists in the UAE are paying around 15 per cent more on vehicle insurance premium compared to last year since January this year, but many of them feel they are not getting back value for the additional money they are paying.

Premiums for both third party and comprehensive insurance for all categories of vehicles were increased after the UAE Insurance Authority revised the unified auto insurance regulations with effect from January.

Apart from a hike in tariff, the amendment to the auto insurance regulations also introduced upper and lower limits to premiums, with the minimum comprehensive insurance premiums restricted to Dh1,300 for saloon cars and Dh2,000 for SUVs, while the maximum cap is at five per cent and seven per cent of the insured value of the vehicles for saloon cars and SUVs, respectively.

The minimum third party premium for a saloon car is Dh750, while the maximum is Dh2,100. For four-wheel drive vehicles, the minimum third party insurance is Dh1,000 and the maximum Dh2,150.

The insured value of the vehicle is decided on the 15 per cent annual depreciation of the vehicle’s market rate, however, according to the new rules, 20 per cent of the insured value will be deducted if the vehicle is written off.

The unified auto insurance regulations also increased damage protection coverage as well as making replacement car mandatory during the repair period, post accident.

The new policies will also include no additional levy of ambulance or medical evacuation fees, which were introduced last year.

However, many consumers say either the benefits are not clearly mentioned in the policy documents or just don’t exist.

“When I applied for the auto insurance last month, I was expecting to see a clause for replacement car in the policy, but it wasn’t there. When I enquired about it with the insurer, I was told it wasn’t mandatory. I was under the impression that under the new laws, it was mandatory,” said Ahmad Shams, an Indian expatriate.

Another expatriate, Mohammad Odeh from Egypt, said that most of the insurers he approached were not willing to issue a comprehensive insurance policy for his 2009 SUV and those who offered were charging way higher than the minimum premium limit.

“I feel the regulations are being implemented only when it comes to hiking the prices. Only one firm agreed to a premium closer to the minimum, but they were forcing me to lower the value of the vehicle much below its market value and I felt they were not offering me most of the benefits,” said Odeh, who is a pharmacist.

According to another consumer, many insurers are refusing to renew policies if there was a claim in the previous year.

“I don’t understand what is the purpose of having an insurance policy if it is not to claim damages in an accident. It should not be legal for an insurer to reject a policy renewal just on a single claim,” said a Pakistani expat, who wished to remain anonymous.

Benefits

Clarifying the doubts of the consumers, experts in the insurance industry said there are indeed some substantial benefits for the motorists in the new regulations.

Jonathan Rawling

“Aside from the added cost, the new regulations do have some pretty substantial changes behind them. For me, one of the most important is the new minimum cap that an insurer can put on third-party property damage, which has been increased from Dh250,000 to Dh2 million,” said Jonathan Rawling, CFO, compareit4me.com.

He added that the previous regime had left the scope for consumers to be substantially under-insured.

“Many consumers were perhaps unaware that some insurance policies were such that, if you caused an accident that resulted in more than Dh250,000 of damage to the other party, you would be personally liable for the difference. So, if you had a policy with a Dh250,000 limit, and you caused Dh750,000 of damage to a Ferrari, you would be personally liable for the missing Dh500,000,” explained Rawling.

Apart from wider damage coverage, he said, the new tariff includes add-ons that will cover the costs of emergency services in the event of an accident.

However, he clarified that the replacement cars for 10 days or Dh300 per day to cover the cost of car rental will be available only to those who are not at fault.

“It means that those who aren’t at fault do not lose out financially if someone damages their vehicle. Now, if someone hits you and damages your car, their insurance policy will either arrange you a replacement car, or else pay you to rent a car for up to 10 days. This means that you are not in danger of being stranded without transport as a result of someone else’s mistake,” he added.

For those who are at fault, they will get a replacement car only if they have purchased additional coverage.

Another benefit of the regulations is standardisation of the wordings of policies, that brings in minimum levels of cover.

“The regulator has stepped in to ensure that when you buy a policy, you can be more comfortable that it is fit for the purpose. It should no longer be the case that consumers buy policies that are “comprehensive” in name but could in fact leave consumers underinsured,” he said.

The replacement car rule is available in both comprehensive and third party insurance.

Wider coverage

Frederik Bisbjerg

Further highlighting the benefits of the new regulations, Frederik Bisbjerg, executive vice-president of QIC Insured, said apart from increasing the maximum cover for property damage, the regulations have also extended liability coverage to husbands, wives, children and parents of policyholders.

Refuting the claims of the consumers that insurers are not complying with the new regulations, he said: “This is new to me, I don’t see how we as insurers cannot comply with the laws laid out and I do not know of any specific cases where a customer has been refused eligible benefits. I fear some insurers might not have been precise enough when explaining the new benefits to the customers and hence created the wrong expectations.”

Responding to the confusion over non-renewal of insurance policies due to previous claims he said: “If a customer has a long or severe claims history, the system calculating the new premium will take this into consideration and the outcome can be a larger premium. I don’t know of cases where insurers directly refuse to renew a car insurance, but I understand that some customers might be surprised by an increase in the premium from the previous year. The new rules are seeking to mitigate this by introducing a maximum premium for the car insurance and hence avoid unrealistically high premiums in case the customer has one or more claims.”

It is important to note that the new regulations apply to policies sold on or after January 1, 2017.

28th March 2016

Health insurance fees and fines in Dubai defined

Shaikh Hamdan Bin Mohammad Bin Rashid Al Maktoum, Crown Prince of Dubai and Chairman of Dubai Executive Council, has issued Executive Council Resolution No (7) of 2016 pertaining to fees and fines related to the health insurance sector in Dubai.

The new resolution supports the provisions of Law No (11) of 2013 concerning health insurance in the emirate.

The resolution authorises the Dubai Health Authority and Dubai Healthcare City Authority to carry out tasks and responsibilities in the most efficient way, including the issuance of permits to claim management companies, insurance firms and health-care service providers seeking to provide health insurance services.

The resolution also empowers the two authorities to supervise the implementation of the health insurance system, and impose fines on violators of the provisions of the above-mentioned Law as well as associated resolutions.

As per the resolution, Dubai Health Authority and Dubai Healthcare City Authority are entitled to collect specified fees and fines, according to their respective jurisdictions. The resolution specifies fees and fines related to health insurance services that each authority can charge.

The resolution stipulates that violators who repeat an offence within a year of the date of the first fine will be charged double the fine up to a maximum of Dh500,000. In addition to the fine, authorities can take further action, including the issuance of warnings to violators and suspension from providing health insurance-related services for a period not exceeding two years, as well as the cancellation of licences.

The annexed Table No (1) associated with the Executive Council Resolution details the fees related to health insurance services, including fees for obtaining and renewing permits for insurance firms, insurance brokers, claim management companies, hospitals, polyclinics and specialised clinics, pharmacies, laboratories, radiology and analysis centres and other related companies.

Table No (2) specifies fines related to 56 violations and provides clear descriptions of each violation. If an insurance company’s licence is revoked, it is required to publish two notifications each on the cancellation of its licence in a local Arabic and English language newspaper. Failure to do so can result in the company incurring a fine of up to Dh150,000. Insurance firms and claim management companies who cease operations before receiving approval from the health authority will be fined Dh100,000.

The chairman of the Board of Dubai Health Authority is authorised to issue the necessary decisions required to execute the provisions of Executive Council Resolution No (7) of 2016, including outlining the terms and conditions as well as the validity of special permits related to conducting health insurance activities.

26th January 2016

Get insurance cover for dependents by June 30, says DHA

Under Dubai’s mandatory health insurance law which makes it mandatory for residents to have health insurance cover by June 30, the sponsors of residents found without an insurance during visa renewal will have to pay fines past the deadline. This means sponsors of spouses and elderly parents must obtain insurance cover for dependants even if the visa is not due for renewal before June 30, a senior official said on Wednesday. Talking to Gulf News on the sidelines of Arab Health 2016, Dr Haidar Al Yousuf, Director of Public Health Funding at the Dubai Health Authority (DHA), said: “Under this law, first there is a legal requirement for every Dubai resident to get covered. The second aspect is to establish who is legally responsible to provide the cover." "In case of employers," he added, "it is simple. But in case of spouses, elderly parents, housemaids and house boys, it is the legal responsibility of the individual who is sponsoring their visa."

27th November 2015

A guide to Dubai’s mandatory Health Insurance Law

You will probably be aware by now that the Dubai Health Authority (DHA) has issued a law requiring all Emiratis and Dubai expats, including dependents, to have insurance in place to pay for their emergency and curative healthcare needs. It follows in the footsteps of Abu Dhabi – which implemented its mandatory healthcare initiative in 2006. While Emiratis will be handled by a Dubai government-funded scheme, Dubai expats and their dependents will be handled under private health insurance schemes. The law applies to all economic areas of the emirate including free zones, with its implementation phased in over the past couple of years, initially targeting companies with 1,000-plus employees then moving to those with more than 100 in July. Now it is the turn of SMEs and micro SMEs, including all dependents and domestic workers, and time is running out. The looming deadline of June 30 next year means companies and individuals need to get plans in place. Until then, those without insurance either have no protection or a government health card which offers care in government health facilities.

13th August 2015

2.7m Dubai residents have health cover

Number has almost trebled on completion of second Phase, with coverage for all by July 31, 2016

Dubai: Nearly 2.7 million Emiratis and expatriate residents have been brought under the purview of the mandatory health insurance cover that completed its second phase last month, while approximately 3.2 million people will be covered by 2016 when it achieves its 100 per cent target of providing at least essential basic health cover to all Dubai residents.

Dr Haidar Al Yousuf, director of the health funding department at the Dubai Health Authority (DHA) which is implementing the law, told Gulf News: “When we started with the first phase in 2014, only one million people had health insurance in Dubai, so the number has nearly trebled by the second phase completion, and by June 31, 2016, every single individual, including families and domestic help, will have basic health cover. I think this will make a big difference to standardization of health care in not just the emirate but in the country.”

The other crucial aspect is the linking of new visas and visa renewal to the health insurance cover. So far, all the companies with above 100 employees were included in Phase 2 of its implementation and the DHA has tied up with the General Directorate of Residency and Foreigners Affairs (GDRFA).

Dr Al Yousuf gave an elaborate explanation of the new system at the GDRFA: “The insurance company that is covering a set of employees in a company issues an insurance certificate for each individual. There are two ways of applying for a new visa or renewal — manual or electronic. If it is manual the GDRFA asks for the insurance certificate copy to be attached with the application. In case the organization is applying electronically for new visas or renewals, automatically a window pops up on the screen asking for the insurance certificates of all the applicants. Scanned copies have to be uploaded to complete the application process. No insurance, no new visa will be issued or renewed for the companies that fall under the purview of the second phase of the insurance law.”

25th September 2014

Maternity Insurance coverage as part of compulsory basic package – Relief for expatriate parents

Dr. Haidar Al Yousuf – Head of Health Funding at DHA has announced that under the new insurance laws passed in 2013, which will cover entire population of Dubai by 2016, will have maternity insurance coverage also, as a part of their basic coverage. The news is of high relevance to expatriate parents, who spend huge amount in hospitals during pregnancy or who have premature babies that demand an extended stay in the Neo Natal Intensive Care Unit (NICU).

The new born will be covered for 30 days in hospital under mother’s policy with the essential benefits package, which is now the minimum accepted cover in Dubai with an aggregate annual limit of Dh 150,000. As per Dr. Al Yousuf, as the new mandatory medical insurance law gets implemented, the essential benefits package also comes into place as a strong support to expatriate parents.

The new law is expected to be enforced with all new policies in Dubai. The eclaim link – DHA’s electronic platform to monitor all transactions related to health insurance and I –promes, - DHA’s online portal to collect all feedbacks and suggestions of the insured, together will make sure that the law is enforced comprehensively and holistically, benefiting all residents of UAE

20th April 2014

Dh 500 per year as the minimum coverage for expats’ dependants:

Ever since health insurance has become mandatory in Dubai, there has been lot of speculations about the minimum health insurance premium for spouses and dependents of the expats, whose family doesn’t get covered by the company they work for.

It is indeed a matter of relief for all, as one can be prepared for spending a minimum of dh 500 per dependant, towards essential health benefits. This special package, exclusively designed for expatriates earning less than dh 4000 per month, was extended by the authorities to serve the income- less dependents.

Currently, only a limited number of insurance companies are authorized to provide this coverage and the basic package has got a wide coverage as the access is not limited to a general consultation with a physician. With the essential health care benefits, people can avail the service of specialists, maternity care, surgical procedures etc. The medical bill payments limit is set as Dh 1, 50, 000 per year. To get coverage for inpatient procedures such as laboratory tests and surgery, the approval of insurance company is required. In emergency medical conditions, prior approval is not required.

During the initial six months, chronic and pre existing conditions of the insured, will not be covered. The co- insurance limits are also set decently to prevent any misuse. However, this is a major step taken by Dubai Health Authority to assure the social security of expatriates by offering medical insurance at an all time low premium and this also goes to show their determination to execute the plans without burdening the people.