A key feature of the health service is the introduction of mandatory health insurance, which finances the medical system in Abu Dhabi. There are now around 2.3 million insurance contracts, more in fact than there are residents, according to HAAD.
Sponsors and employers of resident expatriates have a legal duty to ensure that those on their sponsorship, or in their employ, have valid health insurance in place. Employers are not only responsible for the insurance of their employees, but also their employee’s spouses and up to three children under the age of 18 years.
To enforce compliance by sponsors and employers, the Health Insurance Law provides fines for sponsors and employers that fail to ensure that insurance is in place and provides that they will be responsible for the cost of healthcare services provided to uninsured persons in their employ or under their sponsorship. As a further means of ensuring that employers procure insurance for their employees, no employee’s work permits are issued or renewed in Abu Dhabi, unless evidence is provided that such employees have health insurance.
The regulations specify the minimum cover to be provided by insurance policies, together with standard exclusions. All insurance companies and intermediaries who wish to sell health insurance are required to be registered by HAAD, the Health Authority – Abu Dhabi (insurance providers are also required to have a place of business in Abu Dhabi). Around three dozen insurers have now been registered with HAAD, though many have only a handful of members; by far the largest provider is Daman, the first and by far the largest specialised national health insurance company in the United Arab Emirates.
HAAD is quite serious about policing the health insurance industry, and in April 2010 for instance announced that its Audit Section was pursuing 38 violation cases relating to claims – including suspected cases of fraud, forgery and abuse. A number of these have been referred to prosecutors, in others fines ranging from AED 10,000 to AED 20,000 have been issued to clinics, pharmacies, and medical professionals. The violations included claiming for medical services not provided to patients and replacement of prescription medications with non prescribed drugs. A further violation included employers and/or sponsors not providing continuous health insurance coverage to their sponsored employees who are working and/or residing in the Emirate.
Two companies were also fined for underwriting health insurance policies which cover less medical services than is mandatory under the policies and for non-compliance with the rules and principles in marketing health insurance policies.
Health insurance for Nationals
A programme called Thiqa provides health insurance for Nationals. Thiqa is being operated by the insurance provider Daman, which provides members with a Thiqa card that replaces the existing health cards. The Thiqa card gives each member free-of charge access to a large number of private and public health care providers registered within Daman’s network.
