Executive Regulations to the Dubai Health Insurance Law of 2013 Issued

Changes to the Dubai Health Insurance Law

In November 2013, Law No 11 of 2013 Concerning Health Insurance in the Emirate of Dubai (“Dubai Health Law”) was issued, that made it mandatory for every resident in the Emirate of Dubai to be covered by medical insurance, which was the responsibility of their sponsor. The requirement was implemented in a phased manner until March 2017 and from then onwards it is mandatory for every resident of Dubai to be covered by medical insurance. 

In October 2022 the Administrative Resolution No 78 of 2022 issuing the Executive Regulations of Law No 11 of 2013 Concerning Health Insurance in the Emirate of Dubai (“Executive Regulations”) was issued and it came into force on 17 November 2022, on its publication in the Gazette.

Who does it Impact?

The Executive Regulations to Health Law is relevant to the stakeholders of the insurance industry who deal with health insurance in the Emirate of Dubai and with healthcare providers, including hospitals and clinics who are regulated by the DHA and to whom the Dubai Health Law applies. 

What has changed?

The Executive Regulations does not replace the provisions of Dubai Health Law, but is meant to compliment it, providing more details on the process, procedures and obligations that apply to the various stakeholders of the health insurance industry. This is more relevant in the context that pursuant to the formation of the Dubai Academic Health Corporation in July 2021, the Dubai Healthcare City Authority (“DHCC”) is set to merge with the DHA and the Executive Regulations, and DHA is now the unified health regulator in the Emirate of Dubai.

A number of changes have been brought forth to the obligations of the insurers, TPAs, brokers and health service providers, apart from introducing provisions relating to health insurance portfolio transfers between insurers. For instance, health service provider is not allowed to adjust prices without obtaining prior approval of the Dubai Health Insurance Corporation of the DHA. Provisions relating to obligations of the beneficiaries have been further detailed, requiring beneficiary to notify the insurer with complete and correct medical history and to report to DHA if any misuse, manipulation of the health insurance system takes place. Several new provisions have also been introduced, relating to health services pricing mechanism, approval of prices, rules of health insurance data protection, termination or transfer of health insurance policy, monitoring and inspection and those relating to complaints and disputes.

How can we help? 

The Executive Regulation to the Dubai Health Law has brought forth changes that will impact the manner in which health insurance policies are currently underwritten by the health insurers, the manner they are being sold by the distributors, managed by the TPAs or the manner in which it is priced and provided by the healthcare providers, and calls for a complete prohibition on any act that would affect the duties or obligations or causes a conflict of interest or raises suspicion of conflict of interest in any form.

It is therefore very important for the stakeholders to revisit their respective functions and adjust these to ensure compliance with the Executive Regulations, since they are already in force. We are happy to assist you with review of the insurance policies, internal guidelines, TPA and hospital contracts and distribution arrangements, or advice on any restructure that you may require pursuant to the Executive Regulations.