The Dubai Health Authority (DHA) revealed that it has fined 25 health centers, clinics, insurance brokers and insurance companies for violating the Dubai mandatory Health Insurance law, while it has referred 6 clinics to prosecution for potential fraudulent activities.

The DHA revealed the violations were found during surprise and routine inspections conducted by the Authority’s Health Funding Department as well as from member complaints.

Dr Haidar Al Yousef, the Director of the Health Funding Department at DHA said the fines imposed on these health centers, clinics, insurance brokers and insurance companies ranged from Dh10,000 to Dh80,000.

“Some healthcare providers and insurers didn’t comply completely with the Health Insurance Law and the circulars issued by the health funding department. We observed is through inspection visits, compliance meetings as well complaints received from different parties involved in the system. Therefore we have resorted to fining them to avoid such acts in the future,” he said.

Dr Al Yousef revealed that the violations include but are not limited to:

      Healthcare provider altering the diagnosis to get claims paid.
      Healthcare provider submitting claims for non-performed services.
      Healthcare provider submit partial case details to get coverage and get claims settled.
      Beneficiary abuse the health insurance card.
      Ordering Medical unnecessary services and laboratories.
      Healthcare provider submit the invoices and get payment before even the services done to the members in which in most of the cases the patient don’t come back to complete the services – example: Dental & Physiotherapy Sessions.
      Delay insurance companies in issuing the health insurance cards or activation of the emirates ID.
      Non-compliance of the insurance companies with the customer satisfaction level required by the DHA especially the front desk & employees handling call center.
      Insurer market or advertise wrong information without verification from DHA.
   Insurer practice health insurance in Dubai market without DHA/HFD license.
  Insurer deals with unlicensed companies practicing health insurance in Dubai market without DHA/HFD license.

Dr Al Yousef said that violating facilities received a warning that was followed by a fine and some were even referred to prosecution and might face criminal punishment due to potential fraudulent activities.

The fines range between Dh10,000 to Dh80,000 based on violation and the number of times the violation was repeated— in line with Law No. 7 of 2016 issued by His Highness Shaikh Hamdan Bin Mohammad Bin Rashid Al Maktoum, Crown Prince of Dubai and Chairman of the Executive Council. The law aims to protect the rights of individuals by ensuring that they are covered by the health insurance.

Employers and sponsors who fail to provide mandatory health insurance cover are now liable to a fine of Dh500 per month. Apart from the fine, no new visa will be granted and no existing visas renewed without health insurance, according to DHA