Competition in the Irish Private Health Insurance Market

condition. 91 There are also waiting periods for moving to a contract
with increased benefits and for maternity benefits. 92
6.29 Concerns about waiting periods may have an especially detrimental
effect on older cohorts of PHI customers, who are far less likely to
switch insurers than younger customers. 93 Statistically, older people
have a greater likelihood of claiming on a health insurance policy in
any one time period. As a consequence, older people may be less
willing to switch as they perceive that they run a greater risk of not
being covered by health insurance due to waiting periods.
6.30 It is important for consumer information and awareness of switching
that consumers are not under the impression that they are in any way
restricted from switching due to the need to serve extra waiting
periods. Consumers who have completed their waiting period with one
health insurer do not need to serve an additional waiting period on
switching to a similar plan with another health insurer. Consumers who
decide to switch during their waiting period only have to serve the
balance of their waiting period with their new insurer. 94 However,
consumers who switch to a plan, either with their current insurer, or
another insurer, which provides a greater level of benefits, may have
to serve an additional waiting period to account for the extra benefits.
Recommendation 9
Pending the implementation of Recommendation 10,
PHI companies should send out renewal notices to
insured persons one calendar month prior to the
renewal date. At a minimum, these renewal notices
should give details of current PHI cover and cost of
renewal of cover for a further year, at what age the
insured can avail of reduced premiums, and
information on waiting periods.
Action By
PHI
companies
Provision of Information
6.31 Informed consumers make better decisions about the products and
services which best suit their needs and desires. Without useful,
accessible information, consumers are unable to accurately assess the
merits of competing products. The HIA Market Review found that 46%
of health insurance consumers positively agreed that there was
sufficient information available for consumers to compare plans from
different insurers, although, perhaps unsurprisingly, only 21% of nonconsumers
of PHI reached the same conclusion.
6.32 Less than half of PHI consumers feel there is sufficient information to
allow for useful comparisons of PHI plans. Greater attention therefore
needs to be paid to providing actual and potential consumers of PHI
with simple, comprehensible and accessible information about PHI
plans offered by each of the PHI firms operating in the Irish market.
91 The maximum waiting periods for this category are 5 years for persons under the age of 55, 7 years
for persons aged between 55 and 60, and 10 years for persons aged over 60.
92 The maximum waiting periods for moving to a higher contract are 2 years for a person under the
age of 65 years and 5 years for a person of or over the age of 65 years. No maternity benefits are
payable for the period of 52 weeks following first being named as an insured person.
93 HIA/Insight Market Review, p.37
94 For more information, please see http://www.hia.ie/faq/faqwaiting.html#question7
93