The Consumers Council of Thailand has voiced its disagreement with the Office of Insurance Commission’s co-payment scheme for health insurance, under which the insured will have to pay a portion of their medical costs if they exceed the amount paid in premiums.
There are three circumstances in which the insured will have to shoulder medical fees charged by a hospital or a clinic.
1. If an insured person makes three claims for medical treatment within a year for minor illnesses which amount over 200% of the annual insurance premium, they will have to co-pay 30% of the medical fees for the next year with the insurance company.
2. If the three claims within a year for the treatment of general illnesses exceed 400% of the insurance premium paid each year, the policy holder will have to co-pay 30% of the medical fees for the next year with the insurance company.
3. If there insured makes the claims mentioned in 1 and 2, the insured will have to co-pay 50% of the medical expenses for the next year.
The co-payment scheme, which comes into effect today, will not be applied to insurance policies issued before today. It is intended to prevent the insured from making excessive claims.
Pattharakorn Tepboonrat, deputy head of the Consumer’s Rights Protection Group of the Consumers Council of Thailand, said that the co-payment scheme will not prevent excessive claims, but will add financial burden on the insured instead.
Pattharakorn Tepboonrat, deputy head of the Consumer’s Rights Protection Group of the Consumers Council of Thailand
He suggested that the Insurance Commission pay more attention to the problem of overcharging by private hospitals.
