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Friday, 20 January 2012 16:40

CCM probes health insurance

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The Competition Commission has opened an investigation into the provision of private health insurance by BAI Co. Ltd along with affiliated companies, and the administration of private health insurance schemes by Momentum (Mauritius). The Commission suspects potential breaches of the Competition Act 2007.  Private medical/health insurance is a product which is offered by insurance companies operating in the general insurance segment.
For some of these insurance companies however, the administration of the claim is, for convenience purposes, done by a Third Party Administrator. The CCM will investigate whether private medical/health insurance schemes having a list of preferred optometry service providers, such as optometrists, opticians, and other eyewear suppliers, may be restricting, preventing or distorting competition among optometry service providers. Dr. Sean Ennis, the Executive Director of CCM, said: “Optometry services, in general, are one of the most sought after medical services by insurance customers.

Optometry service providers have to be able to compete on a level playing field in order to provide the best service to consumers who are subscribed to a private medical/health insurance scheme. We think that the preferred list of providers as well as the restrictions to obtain such services from particular optometry service providers may not only restrict consumer choice but also unduly close markets to optometry service providers.

At this stage, the Executive Director has concluded that he has reasonable grounds to believe that such behaviour on the part of BAI and Momentum Mauritius may constitute a breach of the monopoly provisions of the law. The Executive Director will report his findings to the Commission. If the Commission concludes that the effect of these terms and conditions is to restrict, prevent or distort competition in any market, it may take steps to remedy the situation.

Alternatively, the investigation might find no infringement of the Act, in which case the investigation would be closed down without further action. No financial penalties can be levied for a breach of the monopoly provisions of the Act; the focus instead is on taking measures to promote competition.
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