Health Insurance

Health Insurance

Health Insurance:

The health insurance provides medical and health care for individuals in groups, companies, and foundations operating in Palestine in case the policyholder is exposed to an ailment or a disease that requires obtaining medical care from clinics, hospitals, pharmacies, laboratories, radiology centers, and other medical centers.

Health insurance includes medical examination costs, diagnosis, treatment, and physical and psychological support.

The health insurance depends on the principle of risk pooling, which means collecting the risks of the diseases which infect a certain group and sharing them equally between individuals through raising the funds required for the treatments of these combined risks equally, and distributing them between the individuals in accordance with the needs for treatment, which eventually leads to the reduction of burdens and costs arising from the treatment of the medical conditions which the insured may be exposed to, and guarantees access to the medical care for all those who need it for a small and fixed amount of money paid by all individuals covered by the insurance.

Health insurance includes three elements:

  • The first party, which is the insurance company.
  • The second party, who is the insured person or the beneficiary.
  • The contract, the conditions, and insurance coverage.

Types of insurance coverage:

  • Basic coverage
  • Premium coverage
  • Elite coverage

Health insurance funding resources:

  • Individual: The amount is deducted from him/her on a monthly basis or in accordance with the treatment.
  • Private organizations: The company pays a part of the health insurance cost of its employees, while the employees pay the remaining amount of the premium.
  • The government
  • International organizations such as UNRWA.

 

 

Health insurance agreement:

It is an agreement signed by two parties under which each of them pledges to abide by his or her obligation specified in the articles of the agreement. It is usually made of two copies, and are sent with the policy.

Insurance company: It is committed to manage and settlement of the claims in cooperation with a certain company, pay them off and comply with the insurance coverage.

The insured: He undertakes to pay the premiums on time and submit the necessary invoices and medical reports.

The two parties have the right to cancel the contract by giving a thirty-day notice to settle the polices.

Health insurance policy:

It is an annual contract including the total annual premiums, names of the subscribers, policy effective date and its termination, general conditions, coverage, and exceptions. It also specifies the mechanism of submitting the claims by the beneficiary, way of paying them, specifications and participation by the beneficiary.