Private health insurance (FOI)Private health insurance (FOI)
Produced by the Freedom of Information officeAuthored by Government of Jersey and published on
19 April 2021.Prepared internally, no external costs.
Request
Please confirm:
A
How many Jersey residents have private health insurance?
B
What percentage of all the Hospital procedures each year are for patients covered by private health insurance?
C
What is the annual income produced by private patient insurance?
Response
A
Information is not held as to how many Jersey residents hold private health insurance.
B
This response relates to main theatre and day surgery unit operations.
The response excludes minor procedures that are carried out in an outpatient setting or the endoscopy suite. This has been excluded under the Freedom of Information (Jersey) Law 2011 as it does not require a Scheduled Public Authority to manipulate data and would take more than the prescribed 12.5 hours to provide a response.
On average, 21% of all operations are for private patients.
Admission Category | 2018 | 2019 | 2020 | Average |
| Private | 21% | 21% | 21% | 21% |
| Public | 79% | 79% | 79% | 79% |
Table 1: Total operations split by Private and Public admission category for 2018 to 2020
Not all private patient charges are paid for by health insurance providers, patients can elect to self-fund as shown in the table below. Of the invoices raised for private operation charges the percentage sent to private medical insurance providers on behalf of the patient for settlement was on average 77%.
Insurance Category | 2018 | 2019 | 2020 | Average |
| Invoice copy sent to insurance | 78% | 79% | 74% | 77% |
| Invoice sent to patient only | 22% | 21% | 26% | 23% |
Table 2: Total invoices for private operations split by those sent to insurance companies for 2018 to 2020
Estimated 17% of all theatre operations are for patients with private health insurance cover.
C
To provide the exact sum of cash paid by insurance companies is not possible within the time prescribed of 12.5 hours under the Freedom of Information (Jersey) Law 2011.
Invoices are raised to patients and a copy is forwarded to their insurance company for settlement. A smaller payment may be made if there is a shortfall on policy cover or an excess. Equally some patients may not provide HCS with insurance details and forward the invoice themselves to their insurer for reimbursement.
The Government of Jersey does not hold the breakdown of income by insurer for Radiology, Pathology, Clinical Investigations, Audiology.
| | 2018 | 2019 | 2020 |
| Total invoice value for insurance assessment | £6,522,406 | £ 6,658,140 | £ 6,139,896 |
Table 3: Total invoices for private activity sent to insurance companies for 2018 to 2020
Article applied
Article 16 - A scheduled public authority may refuse to supply information if cost excessive
(1) A scheduled public authority that has been requested to supply information may refuse to supply the information if it estimates that the cost of doing so would exceed an amount determined in the manner prescribed by Regulations.
Regulation 2 (1) of the Freedom of Information (Costs) (Jersey) Regulations 2014 allows an authority to refuse a request for information where the estimated cost of dealing with the request would exceed the specified amount of the cost limit of £500. This is the estimated cost of one person spending 12.5 working hours in determining whether the department holds the information, locating, retrieving and extracting the information.
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