Statement of Consumer Rights at Renewal
What rights do I have in relation to renewing my policy?
As a private health insurance customer, you have many rights. You have the right to renew cover regardless of your age, gender or health. All health insurers are obliged to accept all applicants regardless of risk. Once you have health insurance, an insurer cannot stop cover or refuse to renew your insurance, except in limited circumstances such as non-payment of premium or fraud.
Will my age affect my insurance premium?
Until April 2015 everyone was charged the same premium for a particular health insurance plan, irrespective of their age, gender and the current or likely future state of their health. This is called community rating. On 1st May 2015, the Government introduced Lifetime Community Rating legislation. Under this legislation, community rating has been changed to reflect the age at which a person takes out private health insurance. Late entry charges are applied to the premiums of those who join the health insurance market at age 35 or over. Therefore, if an individual did not have health insurance before 1st May 2015 and is aged 35 or over, due to Lifetime Community Rating their premiums may cost more. If an individual takes out private health insurance earlier in life, and retains it, they will pay lower premiums compared to someone who joins when they are older. A discounted premium is available for all children and may be available for young adults. A discounted premium may also be available if you are in a group scheme.
Can I change my health insurance plan or insurer?
You have the right to change your health insurance plan or insurer at your renewal date without penalty. It is also in your interest to review the level of cover that you have at renewal, to ensure the benefits continue to meet your needs at that time.
The insurer may not impose additional waiting periods unless you are upgrading your cover. Even when you are upgrading your cover, an insurer may only impose an extra waiting period in respect of additional cover in the new policy. However, if you allow your health insurance to lapse for 13 weeks or more, you may have to serve your waiting periods again and Lifetime Community Rating loadings may apply to your premium.
What happens if I switch from my current insurer and wish to return to them at a later date?
In general health insurance policies are twelve month contracts. If you switch insurer and later decide you want to switch back, you may do so at your next renewal date. In some cases, insurers allow policyholders to switch contracts during the twelve month contract term. The insurer may charge you a mid-term cancellation fee to do this. The insurer may only impose waiting periods for any extra benefits available on your new plan.
Can an insurer refuse to sell me a particular plan?
No. An insurer must sell you the policy you request. Some plans are marketed towards certain groups such as companies or professions but you are entitled to purchase these plans regardless of whether or not you are a member of the group to which it is marketed.