Health systems’ complaints commissioner presents report against insurers
More than a fifth of the complaints filed by patients against the four public health insurance organizations over their provision of services have been found by the Health System Ombudsman’s Office to have been justified.
An additional 19.5% of the complaints were resolved by the ombudsman’s office, and 21 of the complainants received helpful information and referrals for help.
The report, issued on Tuesday and due to be presented to the Knesset Speaker’s office, covered 16,361 requests for help, including 8,402 complaints that involved problems in transferring to a different health fund, getting retroactive payments for medical services that had been refused and other issues.
The ombudsman (public complaints commissioner) reported that Clalit Health Services, the largest insurer, incurred the lowest rate of complaints, followed by the second largest, Maccabi Health Services. The highest rate of complaints was received against the smallest health fund, Leumit Health Services, followed by Meuhedet Health Services, the third largest insurer.
About half of all the complaints were about the basket of health services supplied by the insurers, followed by administrative dealings with patients, choice of the provider of medical services, emergency services, supplementary health insurances, professional treatment and information.
A Leumit spokesman said that while it had received the highest rate of complaints, it also had the largest number of complaints that were finally resolved and the smallest number of justified complaints.