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«Health Dubai»: 20 thousand dirhams fine delayed approval of insurance applications without excuse

2019-06-09T22:10:17.009Z

Patients have to wait for a period of up to a week sometimes to obtain the consent of the health insurance companies to conduct the required medical examinations, which delay the diagnosis of the disease, and presents the lives of some of them at risk, while the Health Authority in Dubai,



Patients are forced to wait for a period of up to a week at times to obtain the approval of the health insurance companies to conduct the required medical examinations, which delay the diagnosis of the disease, and endanger the lives of some of them, while the Health Authority in Dubai confirmed that the health insurance system to respond to requests for insurance Within seconds, and that the law imposed a 20 thousand dirhams fine in the event that the company delayed in the approval of insurance applications without an excuse or a clear reason. A survey conducted by Emirates Today showed that 66% of the participants were exacerbated by waiting.

Dr. Saleh Abdul-Ghaffar Al Hashemi, Executive Director of Dubai Health Insurance Corporation, said: "The current insurance system is designed to ensure that approvals for health insurance applications are completed within a few seconds of the application. For the company's need for more information.

Al Hashemi told Emirates Al Youm that the law set a fine of 20,000 dirhams if the insurance company or the claims management company refused or delayed the issuance of its consent to provide a health service to the beneficiary without any excuse accepted by the Authority.

He said that the unjustified delay by insurance companies in responding to insurance claims is a flagrant violation of the law. The company is subject to a fine of 1,000 dirhams for each day of delay. The violation may amount to 50,000 dirhams to breach the license terms, Essentially.

He explained that the system currently used is called "e claim link", in which all hospitals offer claims to insurance companies, ensure the speed of response in case the information is clear and sufficient, if the hospital entered early.

He pointed out that some insurance companies follow a special policy, so if the value of the insurance claim for 4000 dirhams, request information and documents that may require special time from the hospital to provide, and then delay the decision on the request, and other hospitals follow the same mechanism in case the value exceeded 1000 dirhams .

He pointed out that the Commission had received complaints from clients about the delay in the determination of health insurance applications, 90% of which was due to a mistake in data entry, lack of documents, or that the employee responsible for insurance claims is not fully functioning.

A number of patients complained to Al-Ittihad Al-Youm that the insurance refused to perform certain radiological and laboratory tests required by the treating physician. One review, which preferred not to be published, indicated that her husband's life was endangered because there was no mechanism for accepting emergency insurance applications and obtaining approval Instant.

She said she had taken her husband, who is suffering from heart disease, to the emergency department of a hospital to be surprised that he could only be helped in two cases, either by paying a large sum of money beyond her financial capacity at that moment, or by waiting for the next day, And identify ways to rescue and protect it from any complications.

She wondered about the usefulness of health insurance, which can not be relied on when needed, especially at the time of serious injuries and sudden symptoms, noting that she spent the most difficult hours that night for fear of deterioration of her husband's condition or suffered a heart attack while in the house, explaining that any patient when exposed Such situations are felt more and more by the tension and distress caused by waiting for approvals, and feel that his health and his life hostage to the decisions of insurance companies, which take into account first and foremost their interests profitability.

For her part, the patient confirmed that she waited more than a week to obtain the approval of the insurance company to conduct treatment sessions requested by the specialist doctor, to be associated with drugs in the face of acute inflammation of the shoulder bones and muscles and linked.

She said she had waited several days before the MRI image needed to diagnose the cause of the pain in her shoulder was approved. The patient explained that the period between her illness and the ability to conduct the first picture to determine the cause of the disease took about 10 days because of the insurance procedures, to return again after conversion to the competent orthopedic specialist, to wait another week to obtain insurance approval to request a doctor who described the sessions of physical therapy as one of the necessary and immediate drugs To combat inflammation.

Another patient, who declined to be identified, said he was suffering from a chronic lack of vitamin D. He confirmed that the insurance company refused to perform a blood test to determine the amount of vitamin to determine the dose to be taken to compensate for deficiency and avoid diseases that may result from lack of body. He pointed out that there are a number of friends who have been suffering from severe diseases and difficult because of the lack of «vitamin D», at a time when the insurance company to examine the detection of blood percentage is unnecessary and most of the time to reject or delay approval for weeks and months.

Insurance companies refuse tests «Vitamin D»

- Insurance companies refuse to approve tests to detect vitamin D and dispense medicines to compensate for body shortages, while medical reports and research have concluded that vitamin D is essential for bones from childhood to aging, Because it helps the body absorb calcium from food, and it causes serious diseases, it can lead to MS, which is an autoimmune disease, which damages the nerves. Studies have also shown a link between low levels of vitamin D deficiency and type 2 diabetes, the most common form of blood sugar disorders, and a close link between low levels of vitamin D and an increased risk of heart attacks , Stroke, and heart disease.

Poll: 65% of customers are dissatisfied with insurance services

Emirates Al-Youm conducted a 24-hour survey on its Twitter account after complaints about problems faced by health insurance customers. The survey asked respondents whether they were satisfied with their health insurance services. Some 65% of the 1,886 respondents said they were dissatisfied with health insurance services. When asked whether their health problems were delayed due to delayed approval of medical insurance, 66% of the 465 respondents responded affirmatively to their response to a number of complaints from patients who confirmed their worsening condition due to delays in medical diagnosis As a result of procrastination in approving the required tests.

Source: emara

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