Complaints in relation to your insurance provider

If you wish to make a complaint in relation to your private health insurance, you should first discuss it directly with your insurer. If you are unable to resolve your complaint, you may contact the relevant regulator. The Health Insurance Authority is one of the four regulators of the Private Health Insurance Market. The Health Insurance Authority enforces all matters under the Health Insurance Acts 1994 to 2019 relating to the carrying on of a health insurance business in the State, operation of the Risk Equalisation Fund and the provision of advice and information to consumers in relation to health insurance. The acts deal with issues such as minimum benefits, LCR and waiting periods

If you are looking to complain about your insurer and if your complaint does not fall under our remit, it may fall under the remit of one of the three other regulators:

• FSPO - If a complaint is in relation to claim disputes, procedure cover, refusal for pre-existing conditions, this would be under the remit of the FSPO (Financial Service and Pensions Ombudsman)The decision of the Financial Services and Pensions Ombudsman is binding on all parties unless the decision is appealed to the High Court. 

• CCPC/Central Bank – Complaints relating to service standards, non-contact from insurers and transparency of information would fall under the consumer protection code. The central bank would governs this and consumers need to be contact to the CCPC (Competition and Consumer Protection Commission) or the Central bank to further these complaints.

• Data Protection Commission – Any complaints in relation to data protection issues would need to be referred to the Data Protection Commissioner

Some useful contact details can be found here