E-Paper
Sign In
Dubai: Can health insurer deny coverage for disease diagnosed recently?
It is important to first check your policy to determine whether it covers the prescribed treatment; if the insurer continues to deny the claim without valid justification, you may escalate the matter
- PUBLISHED: Sun 18 Jan 2026, 9:28 AM
- By:
- Ashish Mehta
- Share:
Question: I have a decent health insurance plan in Dubai. A doctor and his team have suggested a treatment plan for a condition I recently developed. However, my insurance company is not covering many of the procedures. How can I contest this?
Answer: An insurance company is required to pay for health benefits and ensure the beneficiary can access all rights granted under the health insurance policy in accordance with Article 13 (3) of Dubai Health Insurance Law No. 11 of 2013, which states that, “An insurance company must allow the beneficiary to obtain, by all means available, all his rights as determined in the health insurance policy.”
Recommended For You
Stay up to date with the latest news. Follow KT on WhatsApp Channels.
The insurance company must pay for the insured person’s medical treatment as per the policy in accordance with the Article 20 of the Dubai Health Insurance Law.
“Without prejudice to his right to have recourse against the entity legally responsible for payment of the cost of health benefits, the coverage provider will bear the cost of the health benefits provided to a beneficiary in accordance with the health insurance policy.”
Furthermore, the Dubai Health Authority (DHA) has a process for resolving disputes related to health insurance, requiring parties to utilise this system before seeking judicial or arbitral remedies in accordance with Article 21 of the Dubai Health Insurance Law:
“The DHA may establish a system for the settlement of disputes arising out of health insurance, and may make it mandatory for health insurance parties, prior to recourse to the courts or arbitration.”
When filing a complaint with the Dubai Health Insurance Corporation (DHIC), an affiliate of the DHA, the complaint must include the personal details of the person making the complaint, clearly describe the issue, submit all supporting documents, be written in Arabic or both Arabic and English, and follow any additional requirements set by the DHIC. This is in accordance with Article 28 (b) of the Administrative Resolution No. (78) of 2022 Issuing the Implementing Bylaw of Law No. (11) of 2013 Concerning Health Insurance in the Emirate of Dubai.
“a. The DHIC will consider the complaints filed with it regarding the health services covered by the health insurance system or health insurance policies.
b. A complaint filed with the DHIC must:
Contain the personal details of the complainant;
Contain the details of the complaint, including a clear and precise description of the complainant’s requests;
Be accompanied by all the documents that support the complaint;
Be written in Arabic or in both the Arabic and English languages; and
Meet any other requirements prescribed by the DHIC.”
Based on the aforementioned legal provisions, if your insurance company has refused to cover essential medical procedures prescribed by your doctor that are covered in your insurance policy, you may first submit a written complaint to the insurer along with the medical documentation.
If the insurer continues to deny the claim without a valid justification, you may escalate the matter to the DHIC. However, it is important to first check your health insurance policy to determine whether it covers the treatment prescribed by the doctor. You may consider seeking independent legal advice to evaluate whether the insurer’s conduct constitutes a breach of its contractual and statutory obligations.
Ashish Mehta is the founder and Managing Partner of Ashish Mehta & Associates. He is qualified to practise law in Dubai, the United Kingdom and India. Full details of his firm on: www.amalawyers.com. Readers may e-mail their questions to: news@khaleejtimes.com or send them to Legal View, Khaleej Times, PO Box 11243, Dubai.
