Consumer Protection Bulletin Analyses Key Trends in Health Insurance Complaints

• In H1 2017, there were more than twice the number of complaints per thousand policies for health insurance than for other non-life insurance.

• There was a total of 7,709 complaints received in relation to health insurance in H1 2017. This is a significant decrease from 11,756 complaints reported in H1 2014.

• Claims were the most common cause of complaint (48.1%), and 98% of health insurance complaints were resolved within 40 business days

The Central Bank of Ireland has published its eighth Consumer Protection Bulletin (PDF 473.88KB), which analyses complaints from personal consumers in relation to their health insurance policies using data reported by the main health insurance firms.

This bulletin provides a high-level overview of the number of health insurance policies held by personal consumers and the number and nature of consumer complaints received by firms in relation to health insurance.

The key trends include:

• In H1 2017, the companies received a total of 7,709 complaints in relation to health insurance, representing 0.75% of live policies during that period. This is lower than the comparable H1 2014 figure when complaints relating to health insurance represented 1.12% of live policies.

• Complaints per thousand policies relating to health insurance (7.5) were more than double the number for other non-life insurance products (3.0).

• The most common cause of complaints related to claims (48.1%). This contrasts with other non-life insurance, where only 23.2% of H1 2017 complaints related to claims.

• After claims, customer service was the most common complaint, at 32.7% of H1 2017 complaints.  

• 5.6% of complaints received during H1 2017 received redress payments, and the total amount of redress paid out was €223,857

• 98% of health insurance complaints were resolved within 40 business days.

The Central Bank encourages consumers who are dissatisfied with their experience of financial products or services to ensure that they communicate their complaint directly to their financial services provider in the first instance. This ensures that their complaint receives the protections provided by the Central Bank’s 2012 Consumer Protection Code. Under this Code, firms are obliged to seek to resolve complaints and there are strict rules surrounding how a complaint should be handled. If, following the firm’s complaints process, consumers are still not satisfied, they have the right to refer the complaint to the Financial Services and Pensions Ombudsman, a statutory officer who deals independently with unresolved complaints from consumers.

Notes

• For further information on making a complaint about a financial services firm, please see the Central Bank’s consumer hub explainer on how to make a complaint.
• A “personal consumer” means a consumer who is a natural person acting outside his or her business, trade or profession.
• This is the Central Bank’s eighth Consumer Protection Bulletin. The Central Bank will continue to publish these bulletins periodically, covering various aspects of the market.

• The Central Bank published the outcome of a thematic review specifically focused on health insurance on 11^th March 2016. As a result of this inspection, the Central Bank required health insurance providers to enhance the content and presentation of the information contained in policy renewal notices.