National Health Insurance finally sets up Tribunal, announced by Health Minister Robinson

By Dana Malcolm

Staff Writer

#TurksandCaicos, July 5, 2022 – The National Insurance Board Appeals Tribunal is staffed and active, after having had its first meeting on June 28th. The tribunal has been set up to manage appeals about treatment abroad and other issues including reimbursements. At least four cases were to be debated in this 1st meeting according to Health Minister Jamell Robinson. Robinson was speaking at a press conference aimed at giving TCI residents a timely reminder of what kinds of healthcare services are available to them and how they can access them.

Robison says the Tribunal was very important, noting it will be made up of qualified trustworthy individuals.

“The legislation requires that the chairman have five years of experience and that’s the minimum marker because it’s essentially a litigious exercise— looking at everything that has happened within the process.”

In terms of how claims can reach the tribunal he said once an overseas referral was confirmed by the Joint Referral Committee and a regional doctor has accepted the case the person would be free to leave to seek treatment unless they were dissatisfied.

“If an Individual or whoever has decision-making rights for an individual is not pleased with a facility then it is your right to appeal to the board. If the board upholds the decision your next point of appeal is to the tribunal” he said.

Residents will have 21 days to appeal an issue to the tribunal be it monetary or not and the tribunal’s decision is final.

“We all know the minister has discretion but the minister selects the tribunal— so if we have confidence in the persons we are selecting it would be wrong of any minister to override the process. It must be allowed to function as intended.”

While many appeals have to do with the Treatment Abroad Program (TAP) other appeals can also be fielded with the tribunal, including persons seeking reimbursement from the government.

Persons with older cases are encouraged to file their cases with the NHIB so the newly set up tribunal can assess them

“We’re giving a window for those older cases to be ‘grandfathered’ in.” Robinson explained but everything else after that must stick to the 21 day rule.

He maintained that while the process may be slow no one would be left out.

“At no point will anyone not have access to the healthcare they need and that is a very important thing to note. We’ll go to Timbuktu and spend whatever is required because that’s what our law says we are required to do.”