Complaints insurance company

Complaints about your healthcare insurance company

There are several things you can do when you have a problem with, or a complaint about your health care insurance company in the Netherlands. On this page we will provide you with some information about your options.

Write a letter of complaint

Whenever you have a complaint or when you have a disagreement with your health care insurance company, the first step is to contact your health care insurance company. You can make a direct phone call or write a letter of complaint. Describe your complaint thoroughly and ask them to review the decision or complaint. Make sure to mention your name, address and date of writing.

Complaints and Disputes Health Insurance Foundation

If you are not able to solve the disagreement together with your health care insurance company, you might want to consider contacting the “Stichting Klachten en Geschillen Zorgverzekeringen” (SKGZ) (Complaints and Disputes Health Insurance Foundation). This is a Dutch independent and impartial organization that helps solving problems between individuals and health care insurance companies. The SGKZ is divided into two other impartial organizations that are the Ombudsman and the Geschillencommissie Zorgverzekeringen (Health Insurance Disputes Committee).

Ombudsman

The Ombudsman exists to mediate between you and the health care insurance company. You will have to write a letter to the Ombudsman which fully describes the complaint or disagreement. You could use the same letter that you wrote to the SKGZ. Generally speaking, 50% of the mediations turn out to be successful. Making use of the services of the Ombudsman is free of charge.

Health Insurance Disputes Committee

When it is not possible to consult the ombudsman, or when this process is not successful, then you might want to consider submitting your complaint to the Geschillencommissie Zorgverzekeringen (Health Insurance Disputes Committee). As a result your complaint turns into a dispute. After examination, the organization will give a binding decision. “Binding” means that both you and your insurer will have to follow the decision made by the Health Insurance Disputes Committee.

Starting a dispute however is not free of charge, you will be charged €37,- for the examination of your case. These costs will be refunded if the decision turns out positively for you.

Dutch Health authority

Besides the above mentioned organizations, you can contact the Nederlandse Zorgautoriteit (NZa) (Dutch Health authority). This organization operates as an information point, however you can also file a complaint about your health care insurance company. This organization will give you all the necessary information but they are not able to mediate in a dispute between you and your health care insurance company. You can obtain information or file a complaint by writing an email or by contacting them directly by telephone.

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