Acceptance of Supplementary Insurance in Rijswijk
For residents of Rijswijk, the acceptance of a supplementary health insurance policy means that an insurer approves your application for additional coverage. Unlike the mandatory basic health insurance, which must always be accepted, insurers have no general obligation to accept everyone for supplementary policies. They may refuse coverage, require a medical examination, or exclude pre-existing conditions. This article for Rijswijk residents explains how it works, your rights, and practical local tips, including assistance from the Rijswijk Legal Aid Office.
Legal Rules on Acceptance
The acceptance criteria for supplementary health insurance in Rijswijk are set out in the Health Care Insurance Act (Zvw). Article 11(1) Zvw requires insurers to accept basic insurance regardless of your health status or age. This does not apply to supplementary coverage, such as dental or physiotherapy policies—see Article 19 Zvw, which protects insurers' freedom of choice.
Additional rules stem from the Insurance Code (CvdV) and Dutch Civil Code Book 7 (Articles 7:911 et seq. BW), emphasizing fair information and reasonable decisions. Insurers must clearly state their terms and explain refusals. Medical underwriting is permitted, but discrimination based on gender or race is prohibited under the 2013 Amendment Act on Equal Treatment in Insurance.
Differences Between Basic and Supplementary Insurance
Here is an overview of the key differences:
| Aspect | Basic Insurance | Supplementary Insurance |
|---|---|---|
| Duty to Accept | Yes (art. 11 Zvw) | No |
| Medical Examination | Not permitted | May be required |
| Refusal Possible | Only in case of fraud | Based on health, age, or risk profile |
| Exclusions | Not possible | Yes, for pre-existing conditions |
| Trial Period | N/A | Sometimes 30 days |
This shows why acceptance for supplementary insurance in Rijswijk can be more challenging.
Reasons for Rejecting Your Application
Insurers assess risks. Common grounds for rejection:
- Chronic conditions: such as diabetes or heart disease.
- Age: stricter from age 65.
- Prior healthcare costs: high past bills.
- Incomplete information: undisclosed health issues.
Local Example from Rijswijk: Mr. De Vries (52, Rijswijk) with arthritis applies for dental coverage. After examination, the insurer excludes orthodontics; he receives the policy with that limitation.
Health Declaration and Examination
You complete a questionnaire with your application. If in doubt, a medical exam follows. Regulators like ACM and CTR (Central Assessment of Risk Selection) oversee this, including fair competition in areas like Rijswijk.
Rights for Rijswijk Residents in Case of Refusal
Rejected? Here are your options:
- Request the reason: In writing, as per art. 7:941 BW.
- File a complaint: First with the insurer, then with SKGZ.
- Seek alternatives: Compare via online tools for supplementary health insurance.
- Get help: Free advice from the Rijswijk Legal Aid Office or referral to the Rijswijk District Court for disputes.
Be transparent: Concealment may lead to policy cancellation or premium repayment (art. 7:928 BW).
Real-Life Cases from Rijswijk and Surroundings
Case 1: Rijswijk mother with asthma gets physiotherapy coverage with a premium surcharge.
Case 2: Retiree in remission from cancer: refused extra hospital coverage; basic often suffices.
Case 3: Rijswijk student with no issues: quickly accepted.
Acceptance depends on your personal circumstances.
Frequently Asked Questions for Rijswijk
Can an insurer just refuse?
Yes, if motivated. Appeal via SKGZ or the Rijswijk Legal Aid Office.
Disclose pre-existing conditions?
Always; exclusion possible, concealment risky.
Is examination mandatory?
Not always; CTR assesses necessity.
Switching period (Dec 1-31)?
Often more lenient, but check policy terms.
Tips for Rijswijk Residents
Boost your chances:
- Compare providers: Via Independer or Poliswijzer; check acceptance terms.
- Complete fully: Fill out the health form honestly.
- Local advice: Visit Rijswijk Municipality or the Rijswijk Legal Aid Office for personalized guidance.
- Consider group policies: Via employer or Rijswijk associations, often more generous.