Central bank warns health insurers: top-up policies are at risk

Health care costs.

Dutch health insurance companies must continue to modernize their operations and risk management to ensure their long-term solidity, the central bank said on Tuesday.

In particular, the future of top-up policies, which cover treatment not included in the government-determined basic policy – is in doubt, the central bank said in a report on the future of the Dutch health insurance market.

The top up policies, which cover dental care, more physiotherapy and alternative medicine, are commercial products and insurance companies are free to set their own prices and conditions.

When the new health insurance system was introduced in 2006, 93% of policy holders took out additional insurance but that figure has now fallen to 84%.

‘We notice a trend that clients are becoming more cautious. In other words, they will only choose a supplemental insurance when they know they will use specific healthcare, such as physiotherapy or dental treatments,’ said Koen Kuijper, spokesman for health insurance comparison website ZorgWijzer.nl.

‘As a result, supplemental insurances are becoming far less profitable for insurance companies than ever before.’

Insurance companies are now keeping the prices artificially low and some are already making a loss on their supplementary policies, the central bank said.


The central bank recommends insurers agree multi-year contracts with providers, do more in terms of prevention and advice, and use data more cleverly. At the same time, the government should make it possible for insurers to offer multiple year policies so that investment in prevention pays off.

The bank says that increased solvency requirements, falling income and the use of reserves – €5.5 bn in the past few years – to soften premium hikes have taken their toll on insurers capital surpluses.

With healthcare costs set to mount in the coming years, it is increasingly important for insurance companies to ensure their operations are sustainable, the bank says.

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