Health Insurance (Amendment) Act, 2001
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Amendment of definition of “health insurance contract” in Principal Act. |
2.—The following definition is substituted for the definition of “health insurance contract” in section 2(1) of the Principal Act: | |
“‘health insurance contract’ means, without prejudice to section 2A, a contract of insurance, or any other insurance arrangement, the purpose or one of the purposes of which is to provide for the making of payments by an undertaking, whether or not in conjunction with other payments, specifically for the reimbursement or discharge in whole or in part of fees or charges in respect of the provision of hospital in-patient services or relevant health services, but does not include— | ||
(a) a contract of insurance, or any other insurance arrangement, the sole purpose of which is to provide for the making of payments, directly to the person who effected the contract or entered into the arrangement or to any of the persons named in the contract or the arrangement, by an undertaking in respect of sickness, injury or disease of amounts calculated by reference only to the duration of— | ||
(i) the sickness, injury or disease, or | ||
(ii) the treatment of the sickness, injury or disease, | ||
or | ||
(b) a contract of insurance, or any other insurance arrangement, the sole purpose of which is to provide for the making of payments by an undertaking, to or on behalf of a dependent person (within the meaning of the Health (Nursing Homes) Act, 1990 ), in respect of the provision, other than as hospital in-patient services, of nursing care to such a person, or | ||
(c) a contract of insurance that complies with the following conditions— | ||
(i) it provides for the making of payments in respect of the provision of relevant health services but not hospital in-patient services, | ||
(ii) the premiums payable under it are payable on the basis of community rating, | ||
(iii) it is effected by a person (including a body established under the laws of a place outside the State) who— | ||
(I) on 1 May 2000 effected or offered to effect contracts of insurance which, had section 2 of the Health Insurance (Amendment) Act, 2001, been in operation on that date, would have fallen within subparagraphs (i) and (ii), and | ||
(II) on or before that date had been informed by the Minister that he was not required to be registered for the purpose of effecting such contracts, | ||
and | ||
(iv) it is not effected on or after the date (being a date falling after the commencement of section 2 of the Health Insurance (Amendment) Act, 2001), if any, on which the person is entered in the Register pursuant to an application by him in that behalf, | ||
or | ||
(d) a contract of insurance, or any other insurance arrangement, the purpose of which is to provide for the making of payments specifically for the reimbursement or discharge of fees or charges in respect of the provision of hospital in-patient services or relevant health services to persons or any dependants of any of them and the following conditions are satisfied— | ||
(i) neither the said persons nor any such dependants are domiciled or ordinarily resident in the State, | ||
(ii) of the said persons to whom the said contract or arrangement relates who are temporarily resident in the State during the subsistence of the said contract or arrangement— | ||
(I) those persons are so resident for the purpose of carrying out their duties as employees, and | ||
(II) those persons constitute not more than— | ||
(A) 20 per cent of the total number of persons (other than dependants of them) to whom the said contract or arrangement relates, and | ||
(B) 20 of the total number of persons employed in the State by the one person;”. |