Dáil Éireann Debate, Tuesday - 30 November 2021
557. Deputy Louise O'Reilly asked the Minister for Health the reason a spouse can be removed from a medical society that is a restricted membership undertaking as defined in the Health Insurance Act 1994 scheme by their partner without their knowledge upon the breakdown of a marriage and relationship; and if he will make a statement on the matter. [58499/21]
Amharc ar fhreagraThe matter the Deputy raises in her question relates to the business practices of a restricted membership undertaking (RMU). An RMU is an organisation which provides health insurance only to its members, who are generally members of a common vocational or occupational group, and their dependants.
In my role as Minister for Health, I have oversight of private health insurance regulation under the Health Insurance Acts 1994-2020. Under the Acts, open membership health insurers are obligated to provide insurance cover to any person who applies for it regardless of that person's personal circumstances, such as health status or age. RMUs are obligated to provide insurance cover to any person who qualifies as a member, and their dependants, without any requirements as to age. These obligations and other health insurance-specific market rules are overseen by the Health Insurance Authority as the regulator of the market.
In the case where a person ceases to be a dependant of a member, for example where they cease to be married to the member of the medical society or where their spouse ceases to qualify as a member, an RMU is not obligated to continue to provide insurance cover to that person. Depending on the RMU's rules, the member may be required to inform the RMU of a change in marital status within a short period after the change occurs.
Without further details it would not be appropriate for me to comment on the particular circumstance which the Deputy refers to in her question. I would advise if any person is unhappy with the actions taken by any health insurer they should in the first instance make a complaint to that health insurer. If the matter is not resolved to their satisfaction, they can make a further complaint to the Financial Services and Pensions Ombudsman.
