The Social Insurance Agency is strongly criticised for persistent long processing times in cases concerning the reimbursement of healthcare costs abroad and for, among other things, inadequate handling of a delay action in such a case

Summary of the decision: The time taken by the Social Insurance Agency to process a case regarding the reimbursement of the costs of medical treatment abroad was almost 13 months, despite the fact decisions in such cases must normally be taken within 90 days. The agency is severely criticised for its slow processing and for failing to fulfil its service, notification and documentation obligations during the processing.

Five weeks after the individual had requested the Social Insurance Agency to take a decision in the case, the agency rejected the request. Although the Parliamentary Ombudsman states that the Social Insurance Agency should have rejected the request instead for being submitted too early, he does not find sufficient grounds to criticise the agency for examining the substance of the request. He believes, however, that the decision should have been taken earlier. If a request is examined on its merits, such a decision must be taken within four weeks. According to the Parliamentary Ombudsman, a decision to reject a request that has been received too early should be taken much more quickly than this, and normally as soon as possible after it has been received. The Social Insurance Agency is criticised for inadequate handling of the action for delay.

The Parliamentary Ombudsman also notes that the Social Insurance Agency continues to have significant problems with long processing times in cases of reimbursement of medical and dental costs abroad, which is very worrying. The Parliamentary Ombudsman intends to follow developments in processing times in its continued supervision.