Private Health Insurance Decision Reference 2021-0284

• Case Outcome: Rejected
• Reference: 2021-0284
• Date: 23 August 2021
• Year: 2021
• Subject Matter: Private Health Insurance
• Conducts Complained Of: Fees & charges applied
• Finantial Sector: Insurance

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.