Al Salmi: The Rules Sets Out the General Provisions and Regulates the Relationship between the Parties
The Executive President of the Capital Market Authority has issued the Rules for Health Insurance No. 78/2019 as continuation of the efforts exerted by CMA in collaboration with the concerned entities to prepare the legislative and regulatory infrastructure for the “Dhamani” schemes of health insurance for the employees of the private sector, the residents and visitors to Oman.
HE Abdullah Salim Al Salmi, Executive President of the Capital Market Authority said the issuance of the decision represents an advanced step in the preparedness of the legislative infrastructure and legal framework and one of the five steps identified by CMA in the preparatory phase of implementation of Dhamani scheme. Al Salmi explained that the health insurance rules means regulating the business of health insurance in Oman by specifying the obligations of the parties in the insurance relationship i.e. insurers, third party administrators, health services providers, the worker and employer.
Al Salmi said that the health insurance rules sets out the regulatory rules and specifies the legal obligations of each of the parties in the insurance process in four chapters on general provisions governing health insurance market, licensing requirements to carry out the business, the obligations of the parties and a chapter on dispute resolution.
On the key features of the health insurance rules, Al Salmi said that insurance companies licensed to carry out the business, health service providers, third party administrators and others will be obliged to implement an electronic link “Dhamani Platform” to cope with the latest technology related to Dhamani to attain the required benefit from the scheme for added economic value from the insurance market. The rules directs the insurance companies to retain not less than 40% of the insurance premiums in Oman. As to the license to practice the health insurance, the rules sets out a number of licensing requirements with the aim of creating efficient and highly professionally capable insurance institutions.
Al Salmi expressed his happiness with the level of preparedness of the legislative infrastructure in the preparatory phase of the health insurance scheme for the employees of the private sector led by CMA in collaboration with the relevant entities. He pointed out to the issuance of the Standard Health Insurance Policy in the first quarter of this year which details the agreement between the insurance company and the insured as well as containing the benefits available through the Dhamani scheme.
It is noteworthy that the Council of Ministers has approved in its session No. 26/2017 assigning CMA to prepare, in coordination with the relevant entities, the legislations required for implementation of health insurance scheme for the employees of the private sector, residents and visitors “Dhamani”. CMA worked for preparation of implementation of the scheme with the concerned entities such as the Ministry of Health, Oman Chamber of Commerce and Industry, Ministry of Manpower, Public Authority for Social Security, Royal Oman Police and the Oman Insurance Association.