Diederik Schrijvershof and Shannon Möller assist a patient federation in getting the Dutch Healthcare Authority (NZa) to take action against a large health insurer. This health insurer has been acting in violation of the mandatory NZa rules set out in the Regulation on the provision of information by health insurers to consumers (“the Regulation”) for months. In violation of Article 19(1) and (2) of the Regulation, the health insurer made changes to its policy conditions to the detriment of its insured persons without informing them about this or making this information accessible. In addition, the health insurer infringed Article 4(2)(b) and (c) and Article 15(1) of the Regulation. The health insurer did not respond (in a timely manner) to questions from insured persons and healthcare providers about the changes in the policy conditions. Furthermore, the health insurer does not comply with the Code of Conduct for Good Health Insurance 2024, the Integral Care Agreement (IZA) and the Supplementary Care and Welfare Agreement (AZWA). With these violations, the health insurer not only disadvantages its own insured persons, but also other parties involved, such as the healthcare providers concerned.
Maverick Advocaten has been committed to ensuring adequate enforcement of binding rules for health insurers for many years. For more information, see here, here, here, here, here, here, here, here, here, here, here and here. For more information about the rights of healthcare providers and the obligations of health insurers, please visit zorgcontractering.com.
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