Health insurance Imposed on the employer towards his employees in the Emirate of Abu Dhabi where the insurer covers the cost of examining diagnosing and WhatsApp: +971555570005
Health insurance
Imposed on the employer towards his employees in the Emirate of Abu Dhabi
Health insurance is one of the types of insurance intended to provide the necessary healthcare to the insured , where the insurer covers the cost of examining, diagnosing, and treating the insured diseases ,in return for a sum of money paid by the insured or his employer whom he work for him on a daily or monthly basis.
Thus, health insurance is one of the social solidarity systems so no one enrolled in this insurance will bear the costs of his treatment alone, this system works on the principle of distributing the cost of the sick individual’s healthcare to people enrolled in insurance equally, in order to reduce the financial burdens imposed on the insured when suffering from diseases and injuries , according to this definition there is four relationships imposed by the presence of four parties in the health insurance systems, and these parties defined by article (1) of law No.23 of 2005 for health insurance in Abu Dhabi as follows :
• Insured: the person have been insured through the health insurance scheme.
• Employer or sponsor: Employer: a natural or corporate person who within the limits of the Emirate, hires employees or workers for any kind of pay. Sponsor: a person sponsoring a non-UAE national resident.
• The insurer: an insurance company operating in the state and licensed by the authority to provide health insurance services.
• Healthcare provider: government or private health centers licensed by authority to provide healthcare services.
The employer is obliged toward his workers to enroll them in health insurance system and to meet the obligation of this enrollment towards the insurance company, which is responsible for covering all the costs of treating the worker in accordance with the types of diseases and injuries covered by the law, and pays this costs to the medical treatment providers until he is recovered and returned to work which reflects positively on his performance at work, and the employer benefits from his increased productivity as a result of his recovery ,it’s therefore a closed chain from the worker to the employer to the health insurance company to the Healthcare provider ,a chain that ensures the preservation of the rights of each party and his commitment to his duty toward the other parties, however one of the weaknesses in this chain is the failure of the employer to enroll his employees or workers in the health insurance system which is what the law stipulated as article 5 of law No.23 of 2005 concerning health insurance states :
” The employer shall undertake to provide health insurance coverage for all his employees/workers and their family members including an employee’s/worker’s wife and three children under 18 years of age. Every sponsor shall undertake to provide insurance coverage for those sponsored by him who are not covered by the employers, as of the date of arrival in the state. A non-UAE national may not obtain a residence permit or renewal thereof, nor may he be employed, unless after enrollment into the health insurance scheme “
The law that obliged the employer provide health insurance coverage for all his employees/workers did not overlook the possibility that the employer may fail to meet this obligation, so the law specified a penalty for this in article (24) which reads as follow:
” Any employer or sponsor who refrains from subscribing to the health insurance scheme or renewing the health insurance policy is punishable by a fine of not less than 300 Dhs (three hundred) for each month not subscribed for in the health insurance policy. This penalty will be compounded corresponding to the number of persons involved “
The determination of the penalty imposed on the employer or the sponsor for his breach of the obligation to enroll the employees in the health insurance system expresses the interest of the legislator and his keenness to apply this system because of its great benefit for the individuals and society, and the worker’s share is the best in which to maintain his health and safety by providing the necessary treatment for him, under this system the worker will not stand helpless in front of his health problems, but will feel safe and secure, and this system also benefits the employer who gain from the return of the worker healthy to work for him, as well as benefit to the insurance company which is helped by the subscriptions of the insured and their increasing numbers to work efficiently and continue their work which is to cover the cost of healthcare financially, and the last benefit of the health insurance system is for medical service providers who will due to the competitive environment, will develop their medical equipment and improve the efficiency of their medical staff.
Mohamed Mahmoud Al Marzooqi law firm
Attorney / Mohamed Al Marzooqi
Mohamed Al Marzooqi advocates & Consultancy
Lawyer in Abu Dhabi, Dubai – UAE
