Hearing of the claimant

What is the purpose of the hearing?

Before a claims decision is made, the claimant will have an opportunity to express an opinion on the matter in writing and to submit an explanation on the demands and information which may have an effect on its decision.

In practice, a hearing means that the Patient Insurance Centre sends the claimant a copy of the account from healthcare services or a medical expert statement it has obtained, for example, and reserves the claimant an opportunity to file a written rejoinder. The claimant will be heard in respect of such clarifications obtained by the Patient Insurance Centre, which the claimant was not already aware of.

The response is to be written on a separate piece of paper. In other words, no comments should be added to any forms or clarifications previously provided. Please note that the response must be given within the indicated time limit. After the expiry of the time limit, the matter may be decided upon, even in the absence of a response to the letter.

NOTE! No response to the letter is necessary, if the claimant has nothing to comment or add to the matter.

No letter of hearing will necessarily be sent at all, if a hearing is manifestly unnecessary, because, for example, the claim is accepted. In this case, the processing of the matter will directly proceed to the decision stage.

The hearing procedure is based on sections 34–36 of the Administrative Procedure Act.