EN Official Journal of the European Union CE 84/161

(2004/C 84 E/0199)

WRITTEN QUESTION E-0088/04

by Erik Meijer (GUE/NGL) to the Commission

(21 January 2004)

Subject: Excessively high premiums charged by Dutch medical insurance companies to policyholders in neighbouring States to offset deficits in the United States

1. Is the Commission aware that Dutch medical insurance companies are charging higher and higher premiums to their private policyholders living outside the Netherlands, for example the insurance company VGZ, which on 1 January 2004 introduced a monthly ‘foreign fee’ of EUR 35 additional per adult and EUR 17,50 per child?

2. Is it aware also that in the case of this foreign fee no distinction is made between policyholders living near the Dutch border, those living in other EU Member States and those living outside the European Union?

3. What is the Commission's opinion of the fact that this system means that Netherlands nationals living in Belgium, where medical charges are comparable with those in the Netherlands, are forced to contribute to the expenses of Netherlands policyholders resident in the United States, where medical charges are five times higher than in the Netherlands or Belgium?

4. Are medical insurance companies allowed to make additional charges such as these in the European Union and to differentiate between national and foreign policyholders with a view to covering costs incurred outside the European Union?

5. If it has answered the fourth question in the affirmative, does the Commission intend to change this situation by laying down that the level of premiums charged by medical insurance companies within the EU should in principle be the same and that supplementary charges are only permitted if demonstrably significant factors make medical expenses higher in the EU Member State in question?

Source: The Dutch newspaper BN-De Stem of 7 January 2004.

Answer given by Mr Bolkestein on behalf of the Commission

(1 March 2004)

The Commission would inform the Honourable Member that the legislation adopted by the European Union in the insurance sector with the aim of establishing the internal market has put in place a regime based on the freedom to set terms and tariffs. In Case C-59/01 Commission v. Italy (1), the Court of Justice ruled that the principle of freedom to set rates applies in the non-life insurance sector. It held that this principle applies in areas such as compulsory insurance, e.g. insurance against civil liability in respect of the use of motor vehicles. Moreover, it stipulated that the public interest cannot be invoked for the purpose of hindering the freedom to set rates.

Regarding the increases in rates that some Dutch insurance companies are charging policyholders living outside the Netherlands, the insurance premium should be commensurate with the risk for which cover is sought. It may be that Dutch insurance companies with policyholders living abroad consider this to be a factor which increases the risk insured since the medical costs covered by the insurance policy would be higher than in the Netherlands. In fact, management and administrative costs relating to insurance policies for policyholders living abroad are generally higher than for domestic policyholders. Various factors, such as agreements between health insurers, healthcare establishments and the medical profession in the Netherlands, explain this difference in the costs incurred abroad by insurers. These agreements allow Dutch insurers to keep the costs for policies covering risks located in the Netherlands at a level which enables them to offer lower insurance premiums than they could offer for policies covering risks abroad, where similar agreements with the medical profession do not exist. In other words, it would seem acceptable for rates to continue to differ in so far as they are based on objective considerations.

In so far as health costs vary between Member States, insurance premiums should take this into account in such a way as to adequately reflect the situation to be covered by the insurance policy. In addition, it must be pointed out that, although the insurance premium may be higher if the policyholder does not live in the Netherlands, he or she does not have to pay additional charges that account for a significant proportion of the total price (premium and taxes). Such charges are levied on insurance policies for policyholders living in the Netherlands.

As the Commission is not competent to supervise insurance companies, it is not in a position to inform the Honourable Member whether this increase in rates for policyholders living abroad is intended exclusively to compensate for the healthcare costs incurred by policyholders living in the United States. The authorities in the Member States responsible for insurance supervision will be able to indicate whether these increases in rates are intended to make all policyholders living abroad bear the costs relating to policyholders living in the United States.

The Commission cannot intervene to demand that health insurance premiums should be the same amount within the European Union and that rate increases should be permitted only when the circumstances in the Member State concerned lead to a substantial rise in healthcare costs.

(1) ECR I- …