Carrying two health insurance policies

| 01/02/2017

Is a consumer in Grand Cayman allowed to belong to more than one medical insurance scheme? I had thought not, but while in a doctor’s rooms, I overheard someone make a statement that they did have more than one.

Auntie’s answer: Yes, you may take out two separate health insurance policies but there is a caveat to that, which I will explain in a bit. In general terms, though, a Health Insurance Commission (HIC) official pointed out that Section 5 (8) of the Health Insurance Law (2015 Revision) “makes clear that the health insurance legislation does not require more than one health insurance contract (minimum prescribed benefit plan is the Standard Health Insurance Contract) to be effected in respect of any resident in the Cayman Islands”.

However, the official added that there is nothing in the legislation preventing someone from purchasing more than one health insurance contract or buying supplemental medical benefits to augment that provided under the standard plan.

I feel compelled to offer my own two cents here to say that the benefits of that standard policy are in dire need of supplementing, but that’s another story.

Now for the caveat: while you can add a second plan you must divulge that you have done so; there is a section in the claim form that asks that question. To make this point absolutely clear, the HIC official said, “Full disclosure is required because it could be considered fraud if the individual is submitting the same claim to two different approved insurers and obtaining payments for the same claim.”

Under the law, anyone who knowingly makes a false declaration commits an offence and is liable on summary conviction to a fine of $2,000 and on conviction on indictment to a fine of $5,000.

The law mentioned in this column can be found on the CNS Library

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Category: Ask Auntie, Health Insurance Questions

Comments (2)

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  1. Anonymous says:

    It’s not about doubly insuring the same risk. It is about getting keeping insurance for existing conditions, and buying better insurance for conditions that my occur in the future.

  2. Anonymous says:

    Is there not a common law prohibition on doubly insuring the same risk?