Private Health Insurance Decision Reference 2021-0284

Case OutcomeRejected
Subject MatterPrivate Health Insurance
Reference2021-0284
Date23 August 2021
Conducts Complained OfFees & charges applied
Finantial SectorInsurance
Decision Ref:
2021-0284
Sector:
Insurance
Product / Service:
Private Health Insurance
Conduct(s) complained of:
Fees & charges applied
Outcome:
Rejected
LEGALLY BINDING DECISION OF THE FINANCIAL SERVICES AND PENSIONS OMBUDSMAN
The complaint concerns a private health insurance policy.
The Complainant’s Case
The Complainant says that the refund of premium paid to him by the Provider, arising from
restrictions in access to private hospitals as a result of Covid-19, is not what was directed by
the Minister for Health. The Complainant states that he received a refund of 21.37%. The
Complainant submits:
“The Minister for Health has negotiated with the private health insurance providers
to give customers 50% [of] their premiums back for the next three months”.
The complaint is that the Provider failed to issue the Complainant with a refund of 50% of
his premium for 3 months. He says that this was “as intended by the Minister of Health.”
The Complainant says that he pays the Provider more than €600 per month and in his
calculation 3 months equals more than €1,800 which he expected to receive from the
Provider. The refund of premium which he received however, was significantly less than the
figure of €912, which he had calculated.

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