What to do when your health insurer refuses approval or a claim

Is your problem with the insurer or with the treatment?

If the insurer refused a pre-approval or a claim, your complaint is about the insurer. The medical complaint routes look at the care itself. The Ministry of Health and Prevention (MOHAP) says its medical complaint service deals only with medical practice and does not take complaints about financial and insurance matters.¹

If you think the treatment itself went wrong, use the medical complaint guide for your emirate. If the problem is the refusal, use the routes below.

How do you complain about an insurer in Dubai?

To the Dubai Health Insurance Corporation (DHIC), which works under the supervision of the Dubai Health Authority (DHA). It hears complaints about health services covered by any authorised health insurance policy in Dubai.² DHA’s service for members is “Submit an Insurance Complaint through the Unified Complaints System”. It is free and limited to people whose visa was issued in Dubai.³

Your complaint must come from you, or from someone with your power of attorney or a signed release of information letter. It must describe the subject, say what you are asking for and include your supporting documents.²

DHIC will not admit a complaint if:

• more than one calendar year has passed since the dispute first arose
• the matter is before a court, or a court has given a final judgment
• the issue has already been resolved.²

Insurers in Dubai must resolve a complaint within 7 days of receiving it, unless DHA grants an extension.²

Complain to the insurer in writing, then file with DHIC well inside the one-year limit.

How do you complain about an insurer in Abu Dhabi?

To the Department of Health Abu Dhabi (DoH), through “Request for Submitting Health Insurance Complaint”. It covers the Thiqa, Basic, Enhanced and Aounak programmes.⁴

DoH asks for the application form, supporting documents, the rejection letter, your Emirates ID, a residency visa issued in Abu Dhabi and a valid health insurance card. You receive a reference number by SMS and email.⁴ DoH says most complaints are resolved in 30 to 60 working days, and suspected fraud and abuse cases take 36 to 48 months.⁴

The fee list shows AED 100 for “Complaints and appeals submitted against a violation decision by a patient or sponsor”.⁴ The page does not say whether a fee applies to a member’s first complaint about a claim. Ask DoH before you pay.

Attach the rejection letter, because DoH lists it as a required document.

When can you take the complaint to Sanadak?

After you have complained to the insurer and waited 15 calendar days with no written reply, or with a reply you are not satisfied with.⁵ Sanadak was set up by the Central Bank of the UAE in 2023 and takes complaints against insurers the Central Bank licenses.⁵

A complaint is free for consumers. You can submit it up to three years from the conduct, or up to two years from when you became aware of it, whichever is longer.⁵ If you disagree with the decision, you can escalate to the Insurance Dispute Resolution Committee, and an appeal costs AED 500.⁵ Sanadak says that for complaints against insurance companies, you “have to complain to Sanadak first and not to the courts”.⁵

Keep the date of your complaint to the insurer, because the 15 days run from it.

Where can you read more about insurance complaints?

The full routes, with insurer reply times and appeal steps, are in the health insurance complaints guide on medicalinsurance.ae.

If the refusal came after treatment you think went wrong, file the medical complaint as well: Dubai, Abu Dhabi or the northern emirates. Check every date in the deadline calculator.

The small print

DHIC’s jurisdiction is section 4.1.1 of PD-04-2025, the submission rules section 4.1.2, the inadmissibility rules section 4.3 and the 7-day resolution time for insurers and claims administrators section 4.6(f).² MOHAP’s service page says financial and insurance complaints go to the Economic Department, and its FAQ says they fall under consumer protection or the judicial authorities.¹