Saleh al Hashimi, Advisor at DHA’s Health Insurance Corporation at the Year of Zayed closing ceremony in Itihad Museum on 19 December 2018. Photo: Pankaj Sharma/Gulf News Archive

Dubai: All newborn babies — even if premature — will no longer face a wait to get an insurance policy , according to a new directive from the Dubai Health Authority’s (DHA) Dubai Health Insurance Corporation (DHIC).

Procedural Directive no.2 of 2019 applies to all parties involved in health insurance plans in the emirate of Dubai, and takes place with immediate effect.

Saleh Al Hashemi, CEO of DHIC exclusively told Gulf News: “The new directive also explains that a new born is covered under its mother’s health insurance for 30 days or up to the annual limit of the mother’s insurance policy. After that we have directed the insurance companies to immediately provide the child medical insurance cover with the same Table of Benefits as the family’s insurance. There will be no waiting period, even if the child is born premature.” he said.

“If a child is premature, he is born with it, it’s not like an employee with chronic diseases joining who may have to wait for six months to get coverage for pre-existing conditions, as imposed by some policies in line with international standards,” added Al Hashemi.

“So as soon as the annual limit or 30 days period under the mother’s policy is over, the newborn will be enrolled under the same health insurance scheme as that of the parents. Of course the new policy for the newborn will be subject to underwriting conditions of the said group or individual policy. However, Lower Salary Band (LSB) members will not be subject to underwriting.”

Bills running too high

Al Hashemi said those cases where bills have run too high will be studied on individual merit: ”Nowhere in the world do insurance companies have such a low index rate of 550 per annum for essential benefit packages. We are trying to provide essential access to healthcare to all. From health insurance cover of just 800,000 people we now have covered 4.7 million in a span of four years. We have particularly focussed on LSB employees and we work towards long-term sustainable programmes with the 12 licensed companies providing Essential Basic Plan (EBP) packages to the lower income groups. These companies know they cannot have all winning cases. In a pool of several employees there could be a case or two where insurances might have larger bills to pay.”

In those cases where families need help, they can apply for assistance. Al Hashemi added: “There are several government funds and private funds and parents could apply to these, but these will be treated as one-off cases and are subject to eligibility criteria for each fund.”

Al Hashemi said the average premium of insurance policies in Dubai as per 2018 is Dh5,370 with more than 80 per cent insurance expense being borne by the employers.

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Image Credit: Supplied

“Insurance works on the principle of risk pooling,” he said. “Insurance companies are publicly listed companies. However, they support CSR initiatives especially since it is highly encouraged in the UAE.”

Talking coverage protocol of insurances in other countries, Al Hashemi said there is no one insurance paradigm in the world.

“In the UAE, we have 200 plus nationalities living. We are evolving. Earlier congenital conditions in newborns were not covered under EBP, now we cover these. We are continuously trying to improve it.”

Seeking other options

He also said that several other initiatives were under study especially for special cover for senior citizens, dental cover and people of determination.

“Earlier cancer cover was limited to policy sum insured but now under Basmah initiative we cover LSB members diagnosed with colorectal, cervical and breast cancer beyond the sum insured at our Oncology Center of Excellence provided that the patient joins the programme upon first diagnosis and we already have about 31 patients under this initiative being treated for these cancers.”

He reiterated, “In the end, it is imperative to understand the framework of insurance. Insurance companies are publicly listed companies, their shareholders expect profits, and they have been established for willing individuals to transfer risk before an event takes place, not after the event has occurred. If individuals purchased adequate cover to meet their needs before they need the insurance, it will protect them financially in unforeseen circumstances.”

What is new?

Insurance companies can no longer enforce a waiting period of any kind before providing coverage to new born babies. Instead they must issue insurance to all new borns within 30 days of birth, even if they were born premature. Previously insurance companies could enforce a waiting period on account of delays in getting a child documented, but if anything happened to the child within that timeframe families were left without coverage.