Oireachtas Joint and Select Committees

Thursday, 25 October 2012

Joint Oireachtas Committee on Health and Children

Health Insurance Sector: Discussion

10:00 am

Photo of Ciara ConwayCiara Conway (Waterford, Labour) | Oireachtas source

On Deputy Naughten's point about enacting the guidelines to ensure balance is brought into the system, it may be a crude comparison but in respect of motor insurance, if someone has been driving since the age of 18, he or she has a no-claims bonus and that is accounted for, but we do not have the same incentive in the health insurance market even though the guidelines exist but have not been implemented. What is the reason for that?

To develop a point Deputy Ó Caoláin raised, figures I received from the Health Service Executive on outstanding amounts among private health insurance companies for treatment provided to private patents are in the order of €204 million. Of that €204 million, €100 million relates to claims under preparation in hospitals, something this committee has discussed previously. However, there is €104 million outstanding relating to claims submitted to insurers that are either being processed or are pending. The witnesses said in response to Deputy Ó Caoláin that it is a matter between the health care providers and the companies but as a health insurance authority, if the witnesses believe there is a practice whereby health insurance companies are withholding payment at the expense of the public purse, what can the HIA do to ensure that that substantial amount of money, based on the figures I received from the HSE, is paid? What action, if any, will the HIA take to address that?

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