With every passing day, complaints against insurance companies pile up.

According to reports in the local media, the insured will be the victims if a solution is not reached any time soon.

The problem of the insured could become a phenomenon if consultants refuse to deal with medical insurance companies and force patients to pay the costs of treatment.

The Council of Cooperative Health Insurance received 1,600 complaints last year with an increase of 56 percent over the previous year. The council said that more than 96 percent of these complainants have been resolved according to regulatory procedures, 3.5 percent have been referred to other relevant bodes and 0.2 percent have been kept on file.

Mohammed bin Salman Al-Hussein, secretary-general of the council, said most complaints are related to not receiving basic benefits which have been documented at the council. Other complaints are related to the refusal of employers to insure employees and their families.

Sobhi Batterjee, president and executive director of a prominent group of private hospitals, said some consultants have different points of view related to treating or refusing to deal with insurance companies because insurance companies are sometimes late in paying doctors or may reduce approved fees. They might refuse to pay for lab tests under the pretext that they are not an essential part of the treatment.

Fouad Azab, director general of a private hospital, said the refusal of consultants to deal with insurance companies is becoming a phenomenon that exists in countries like the US, Britain and France. Some say reasons behind this refusal are purely material, while others say they are rebelling against laws and regulations that stand in their way of giving patients their rights. They want to be free of insurance restrictions that limit their practice.

Naif Al-Reifi, spokesman for the Council of Cooperative Health Insurance, said medical insurance companies pay money to service providers for treatment and the level of this service is governed by a contract between the insurance company and the service provider. Some consultants are not covered in these contracts which means that they aren’t committed to the insurance policy.

He said the Health Insurance Council has a unified policy with a number of conditions in addition to rights and duties. This policy aims to regulate relations between the service provider, the insurance company and the insured to provide health services and safeguard patients’ rights. If violations exist in terms of offering treatment, the insured should complain to the Medical Insurance Council which studies the case and obliges the company to cover expenses.

The Council of Cooperative Health Insurance revealed that the number of insured people reached 9.6 million in 2014, while service providers stood at 2,521, through 28 insurance companies. The health insurance market stands at 52 percent of the total insurance market, and paid claims reached 57 percent in 2014.

Sources quoted by the local media at the Ministry of Health confirmed that the ministry is committed to applying rules and regulations against consultants who refuse to accept insured patients in their clinics.

Punishments could reach SR80,000, while establishments that employ the consultant are penalized SR100,000.

Legal consultants said these punishments are subjected to the articles of the insurance policy and the nature of the contracts signed between service providers and insurance companies.