2023-04-26 22:07:39
The Emirates Insurance Association reported that the benefits that employees and their families receive under the umbrella of health insurance are determined in advance in agreement with business owners, companies and individuals themselves if they purchase documents for their families.
The association confirmed that the benefits schedule depends on the price of the policy, and what the employer requires if the insurance is group, or what he himself determines if he buys the policy for his wife or children.
complaints
This came in response to what Emirates Today received from insured complaints, which were denied insurance coverage related to childbirth or major surgeries, as they explained that the average cost of childbirth ranges between 30 and 35 thousand dirhams, along with the cost of surgeries, which amounts to 200. A thousand dirhams.
They considered that there are essentials that business owners should be obligated to cover, including cases of childbirth and dangerous surgeries, which constitute a great burden on employees.
And some of the insured indicated that the cost of health insurance policies is less expensive when purchased collectively, and does not cost large sums such as those that the employee pays individually for a major birth or surgery.
Happening
For his part, the head of the Health Insurance Committee at the Emirates Insurance Association, Abdul Mohsen Jaber, told «Emirates Today» that health insurance contracts are diverse in many ways, such as coverages, exceptions and additional benefits, and there are minimum limits for coverage governed by local health insurance laws.
He added that any insurance contract is concluded by agreement between the two parties, noting that there are no insurance coverages without a ceiling at the level of the countries of the world, as a clear agreed-upon benefits schedule must be defined, from which the insured benefits, and companies are committed to the coverage.
document
Jaber pointed out that many of the problems and complaints come from the insured’s lack of knowledge of the benefits that can be covered and those that are rejected, because they were originally not included in the policy, and it was not agreed on its comprehensiveness, in addition to that some companies or individuals look at the price of the policy, how much it costs, and ask the minimum legally permissible.
He stressed that it is necessary for institutions and individuals to read the terms of the document well, understand its benefits, and ask regarding its terms before purchasing, in order to avoid future problems.
Jaber stated that the largest percentage of health cases are covered, while the lowest percentage of claims are rejected, in addition to that there are other cases that are exceptionally studied, but in general, insurance companies implement what was agreed upon in the health insurance contract.
mediator
Jaber advised business owners of the importance of conducting awareness sessions, and giving copies of the health insurance policy to employees to read and understand the table of benefits in it to know the details that they can make observations on or request the addition of some other benefits or cases to be covered, if there is a circumstance that requires that, or a major surgery, and other health conditions.
He pointed out that some people can seek the help of an insurance broker to help them purchase health insurance policies, and give them the necessary guidance for the coverages that are commensurate with their requirements and health conditions.
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