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HAAD Announces Cases of Suspected Health Insurance Fraud

The Health Authority – Abu Dhabi (HAAD) has announced that 39 violation cases had been uncovered and parts of it referred to prosecutors after the inspectors discovered suspected cases of fraud and abuse. Other parts were referred to the legal affairs at HAAD to issue fines.

HAAD’s Health Insurance Regulation Department revealed that it has made over 600 inspection visits in 2009 to select public and private providers in the Emirate of Abu Dhabi to monitor the compliance with health insurance law.Engineer Zaid Al Siksek, CEO of HAAD, said: “The inspections are part of HAAD’s continuous monitoring of the compliance of all participants with the health insurance law to make sure that everyone has access to health services and that companies and individuals are protected from fraudulent and abusive behavior. “We conduct all of our inspections with the highest degree of professionalism, our inspectors are accredited by the Ministry of Justice and hold Judicial Officer status”, he added.The Authority indicated that it started sending inspectors on a regular basis to institutions in accordance with the health insurance law, which states the need to monitor the functioning of the health insurance program and ensure compliance by beneficiaries, health providers and insurance companies licensed to operate in the Emirate.HAAD also stated that it normally informs the companies of the inspection visit and the documents required by the Authority during the visit, however is authorized to carry out visits without prior notice in the event it receives a complaint against a specific company that requires immediate action.Ahmed Al Kindi, Section Head Grievances and Appeals in the Health Insurance Regulation Department at HAAD emphasized that HAAD encourages everyone to come forward and report cases of suspected fraud and abuse. Confidentiality of any such complaint is ensured.

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