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Published 31st March 2004, 12:45pm

Cayman Net News

Greater assistance in dealing with health insurance complaints and disputes is now available for the insured public, with the formation of the Health Insurance Commission (HIC) and the commencement of the landmark (HIC) law, which came into effect this month.

The commission's Chief Executive Officer Mervyn Conolly said: "The primary purpose of the law and the commission is to ensure that the provision of health insurance to the public is well regulated."

Mr Conolly, who is also the superintendent of health insurance, pointed out that the Health Insurance Commission Law, in conjunction with the amended Health Insurance Law and Regulations, had strict enforcement powers and increased penal provisions.

"I look forward to working with the HIC and our stakeholders, to prevent the difficulties previously experienced through inadequate enforcement of the Health Insurance Law and Regulations," he said.

The primary role of the HIC, established under section 3 of the Health Insurance Commission Law (2003), is to monitor the performance of the health insurance industry.

Also it must provide five vital functions: Advising the minister responsible for health insurance on any matter relating to health insurance, requiring every health care facility and registered health practitioner in the Cayman Islands to file with the HIC, annually and at every adjustment, the fee charged for each health benefit they provide, investigating and settling disputed claims to health benefits, and answering questions arising in connection with the provision of health insurance, providing advice to the Governor-in-Cabinet on the premium rates charged by health insurers, and managing the Segregated Insurance Fund (SIF), including the collection of money from premiums charged by approved insurers to cover medical costs for indigent people.

In addition to the commencement of the law, the Ministry of Health Services has announced the names of those who serve as members of the Health Insurance Commission.

They include: Suzanne Look Loy, government lawyer and chairperson of the commission, Andrea T Bryan, permanent secretary of the Ministry of Health Services, Dr Gerald Smith, chief medical officer of the Cayman Islands, Dr F Robert Glatz, medical doctor and representative for the Cayman Islands Medical and Dental Society, Peter Small, accountant, Geoff Scholefield, health insurance specialist and representative for the Cayman Islands Health Insurance Association, Carole Appleyard, health insurance specialist with the Cayman Islands National Insurance Company (CINICO), Vincent Frederick, representative of the public, and Mervyn Conolly, chief executive officer of the Health Insurance Commission and superintendent of health insurance.

Cabinet-level responsibility for health insurance rests with the Minister of Health Services, the Hon Gilbert McLean.

He said: "I anticipate that problems being experienced with health insurance, including the enforcement of the laws and regulations, investigation of complaints and resolution of disputes, will be appropriately addressed with the commencement of the Health Insurance Law (2003) and the establishment of the Health Insurance Commission."

The Health Insurance Commission office is in UBS House, second floor, Elgin Avenue, George Town. The telephone number is 946-2084. The fax number is 945-8961.