S.I. No. 39/1925 - Approved Societies Amendment Regulations, 1925.

SAORSTAT ÉIREANN. STATUTORY RULES AND ORDERS. 1925. No. 39.NATIONAL HEALTH INSURANCE.

APPROVED SOCIETIES AMENDMENT REGULATIONS, 1925.

REGULATIONS, DATED 26TH SEPTEMBER, 1925, MADE BY THE IRISH INSURANCE COMMISSIONERS WITH THE CONCURRENCE OF THE MINISTER FOR LOCAL GOVERNMENT AND PUBLIC HEALTH, UNDER THE NATIONAL HEALTH INSURANCE ACTS, 1911 TO 1925.

The Irish Insurance Commissioners in exercise of the several powers conferred on them by the National Health Insurance Acts, 1911 to 1925, and with the concurrence of the Minister for Local Government and Public Health hereby make the following Regulations:—

1.— These Regulations may be cited as the National Health Insurance (Approved Societies) Amendment Regulations, 1925, and shall be read as one with the National Health Insurance (Approved Societies) Consolidated Regulations, 1918 to 1924 (hereinafter referred to as the "Principal Regulations"), and these Regulations and the Principal Regulations may be cited together as the National Health Insurance (Approved Societies) Consolidated Regulations, 1918 to 1925.

2.—(1) The following paragraph shall be added immediately after paragraph (b) of Article 43 of the Principal Regulations:—

"(bb) any other improper payment of benefit where the Society or branch satisfies the Commissioners that the payment in question has not been made in wilful breach of the provisions of the National Health Insurance Acts, 1911 to 1925, or of any regulations made thereunder, and that, in the special circumstances of the case, the payment may reasonably be treated as expenditure on benefits."

3.—Article 49 of the Principal Regulations, as substituted by Article 7 of the National Health Insurance (Approved Societies) Amendment Regulations, 1922, shall have effect as if in paragraph (4) thereof the words "within the period prescribed by regulations made for the purposes of Section 17 (b) of the Act of 1918" were substituted for the words "within four weeks of the date of the notice thereof."

4.—In paragraph (aa) of Article 46 of the Principal Regulations (which paragraph was added to the said Regulations by Article 6 (1) of the National Health Insurance (Approved Societies) Amendment Regulations, 1922) for the words "such sum as may hereafter be prescribed" there shall be substituted the following words:—

"a sum at a rate not exceeding the proportion stated below of the amount paid by the Society or branch out of sums available under the scheme for provision of that benefit in the year, viz.:—

(a) for the year 1921, ten per cent.

(b) for the year 1922, seven and one-half per cent.

(c) for the year 1923 and each subsequent year, five per cent.;

" Provided that in respect of the period up to the 31st day of December, 1922, the following proportions may, if a Society so deisres, be substituted in the case of that Society for those stated above, viz.:—

(a) for the year 1921, nothing.

(b) for the year 1922, ten per cent.

"Provided also that in respect of any amount so paid by the Society or branch which is declared by the Commissioners to be capital expenditure there shall be substituted for the above proportions such portion of the amount as the Commissioners may determine."

5.—The Schedule to the National Health Insurance (Approved Societies) Amendment Regulations, 1922, shall be read and have effect for the year 1921 and subsequent years as though the following provisions were inserted therein after paragraph (2) :—

" (2a) If a Society or branch whose scheme for the distribution of additional benefits includes an increase of sickness or disablement or maternity benefit has accepted a transfer of the engagements of a society or branch which has no scheme providing for an increase of any of such benefits, then for the purpose of determining what further amount may be carried to the administration account under the proviso to the foregoing paragraph, the number of members shall, so long as persons who were members of the last-mentioned society or branch are not entitled to such increase, be reduced by a number representing the membership of that society or branch during the latest year during the whole of which that society or branch was empowered to transact business under the principal Act.

"(2b) If a society or branch which has no scheme providing for an increase of sickness or disablement or maternity benefit has accepted a transfer of the engagements of, or has amalgamated with, a society or branch having a scheme which does so provide, there may, during the currency of such scheme, be carried to the administration account of the first-mentioned society or branch, or, in the case of an amalgamation, of the amalgamated society or branch, in addition to the amount referred to in paragraph (2) of this Schedule an amount calculated at the rates specified in the proviso thereto for every person who was a member of the society or branch having a scheme providing for such increase during the latest year during the whole of which that society or branch was empowered to transact business under the principal Act."

6.*—The date as from which any pension, grant or allowance granted to any insured person in pursuance of any of the Acts mentioned in Section 2 of the National Insurance (Part I. Amendment) Act, 1915, or any similar Act hereafter passed to which that Section shall be applied, as therein provided, by Regulations made by the Commissioners with the consent of the Minister for Finance, shall be treated, for the purposes of Section 11 of the principal Act, as if it were compensation under the Workmen's Compensation Act, 1906, shall be the first day of June, 1915, or the date as from which the pension, grant or allowance has been granted to the insured person as aforesaid, whichever is the later.

7.**— Section 2 of the National Insurance (Part I. Amendment) Act, 1915, shall apply to any Government scheme for compensation in respect of persons injured in any merchant ship or fishing vessel as the result of hostilities during the European war.

8.—In paragraph (1) of Article 25 of the National Health Insurance (Approved Societies) Consolidated Regulations, 1918 (S. R. & O. 1918, No. 932) (which relates to the rate of interest to be credited to Approved Societies on sums standing to their credit in the Investment Account), there shall be substituted for the words "four per centum per annum" the words "four and one-half per centum per annum." This Article shall have effect as from the 1st day of January, 1923.

9.—Where, in pursuance of the Army Pensions Act, 1923 , relating to pensions of officers and soldiers discharged from the armed forces of Saorstát Eireann as medically unfit for further service in consequence of wounds received during such service there has been granted to any person to whom Sections 20 to 25 of the National Health Insurance Act, 1923 , as amended by Section 5 of the National Health Insurance Act, 1924 , applied, or who was an insured person at the date of his discharge from the armed forces, a pension in respect of disablement in the highest degree, the rate of any sickness or disablement benefit to which that person may be entitled in respect of his insurance under the National Health Insurance Acts, 1911 to 1925, shall throughout the period in respect of which that pension or a pension of a greater amount granted in lieu thereof, is payable, be reduced by seven shillings and six pence a week, notwithstanding anything in the said Acts to the contrary.

* This Article supersedes the Provisional Regulations entitled the National Health Insurance (Injuries in War Compensation) Regulations, 1915, which were made, and came into force, on October 26, 1915

** This Article supersedes the Provisional Regulations entitled the National Health Insurance (Injuries in War Compensation) Regulations, 1916, which were made, and came into force, on March 24, 1916.

Provided that a person to whom such a pension has been granted shall not be subject, or shall cease to be subject to such reduction in the rate of benefit—

(i) as respects sickness benefit if he proves that since the date of his discharge from the armed forces he has been employed within the meaning of the National Health Insurance Acts during twenty-six weeks, whether consecutive or not, and that twenty-six weekly contributions have been paid in respect of him; and

(ii) as respects disablement benefit if he proves that since the date of his discharge from the armed forces he has been so employed during one hundred and four weeks, whether consecutive or not, and that one hundred and four weekly contributions have been paid in respect of him.

10. (1) The Society, Committee, or other body by which the sickness and disablement benefits of any such person as referred to in the last preceding Article are administered may, pending the settlement of his claim for pension, pay him benefit at the unreduced rate and where benefit at the unreduced rate has been paid pending such settlement the amount of the difference between the benefit at the unreduced rate and at the reduced rate for such period shall be treated as an advance, and shall, without prejudice to any other method of recovery, be recoverable by deductions from or suspension of any benefits which may subsequently become payable to the person in question.

(2) Any payment purporting to have been made under this Article, pending the settlement of the member's claim for pension, but actually made after the settlement of that claim, where at the date on which the payment was made the Society or branch had not received notice that the settlement had been made may be treated as expenditure on benefits so far as not otherwise recovered.

11. Where sickness or disablement benefit has been paid in error to a soldier in respect of the period of his service in the armed forces of Saorstát Éireann between the first day of April, 1922, and the date of the passing of the National Health Insurance Act, 1923 , the Society, Committee, or other body administering the benefit shall be entitled to recover the amount so paid by deductions from or suspension of any benefits which may subsequently become payable to the person in question.

12. The following Article shall be substituted for Article 44 of the Principal Regulations:—

44. Every improper payment of benefit not treated as expenditure on benefits as aforesaid shall, in so far as not recovered before the expiration of the second year after that in which the payment was made, be charged to the Administration Account of the Society or branch for the said second year.

GIVEN under the official Seal of the Irish Insurance Commissioners this 26th day of September, in the year one thousand nine hundred and twenty-five.

PIERCE KENT,

A person authorised by the Irish Insurance Commissioners to act on behalf of their Secretary.