Article 10 of the Saudi Cooperative Health Insurance Law
المادة 10 من نظام الضمان الصحي التعاوني
The employer bears the cost of treating the insured beneficiary in the period between the date the treatment becomes due and the date of subscription to cooperative health insurance.
Official text (Arabic)
This article has not been amended since the law was issued.
يتحمل صاحِب العمل تكاليف عِلاج المُستفيد مِن الضمان في الفترة التي تنقضي بين تاريخ استِحقاق العِلاج وتاريخ الاشتِراك في الضمان الصحي التعاوني.
This is the official Arabic wording, the only legally binding version. We do not translate the law itself; the explanation below is ours. Official source: Bureau of Experts at the Council of Ministers
Article 10 explained in plain English
This article closes a time gap in which a beneficiary may be left without coverage. If the beneficiary becomes entitled to treatment before his subscription to cooperative health insurance is completed, the employer is the one who bears the cost of his treatment during this period.
The period in question has a beginning and an end:
- Beginning: the date the treatment becomes due.
- End: the date of subscription to cooperative health insurance.
The practical meaning is that delay in subscription does not make the beneficiary bear the cost of his treatment in that period; the employer bears it. This pushes the employer to subscribe promptly so as not to bear the costs directly.
The article itself does not specify when "entitlement to treatment" begins, and does not mention a maximum limit for the costs; these details are not derived from the text.
The article is linked to Article 9, which makes the arrangement of preventive measures in the period before the policy is issued subject to a decision of the Minister of Health, as both articles concern the time before coverage takes effect. It also comes before Article 11, which allows the services covered by the policy to be provided to its holder in government health facilities for a fee borne by the health insurance body.
In a dispute over bearing these costs, it is advisable to consult a lawyer who specializes in health insurance cases.
Practical example
A new worker arrived at an establishment in Buraidah and became entitled to treatment before the establishment completed his subscription to health insurance, and then he needed urgent treatment. Under this article the establishment, as employer, bears the cost of his treatment in the period up to the date of his subscription.
Translated from our Arabic explanation with machine assistance. For guidance only; it does not replace advice from a lawyer on your situation.
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Frequently asked questions about Article 10 of the Saudi Cooperative Health Insurance Law
Who pays for a worker's treatment before insurance is issued?
The employer bears the cost of the beneficiary's treatment in the period between the date the treatment becomes due and the date of subscription to the insurance.
Does the worker bear treatment costs if the insurance is delayed?
The article makes the employer bear the costs of treatment in the period between the date treatment becomes due and the date of subscription.
Is there a maximum limit on what the employer bears?
The article does not mention a maximum limit for these costs.
More articles on Employer's Health Insurance Subscription
- Article 3
Anyone who sponsors a resident must subscribe to cooperative health insurance for him, and a residence permit is not granted or renewed without a policy covering the period of residence.
مع مُراعاة مراحِل التطبيق المُشار إليها في الفقرة (ب) من المادة الخامسة، وما تقضي بِه المادتان الثانية عشرة والثالثة عشرة مِن هذا النِظام، يلتزم كُل من يكفل مُق
- Article 8
The employer may expand cooperative health insurance services through additional appendices at additional cost to include diagnostic and treatment services beyond those in Article 7.
يجوز لصاحِب العمل توسيع مجال خدمات الضمان الصحي التعاوني ،بموجب ملاحِق إضافية، وبتكلِفة إضافية لتشمل خدمات تشخيصية وعلاجية أُخرى أكثر مِّما نُص عليه في المادة ا
- Article 13
The Council of Health Insurance may, by decision, exempt institutions and companies that own qualified private medical institutions from subscribing for the services they provide to their personnel.
يجوز بقرار مِن مجلِس الضمان الصحي إعفاء المؤسسات والشركات التي تملك مؤسسات طبية خاصة مؤهلة من الاشتِراك في الضمان الصحي التعاوني عن الخدمات التي تُقدِّمُها لمنس
- Article 15
A resident who is not under a work sponsorship takes the employer's place in the obligations the employer would otherwise bear under the Cooperative Health Insurance Law.
يحل المُقيم غير المشمول بكفالة عمل محل صاحِب العمل في الالتِزامات المُترتِبة على هذا الأخير بموجب هذا النِظام.
The texts are reproduced from the official website of the Bureau of Experts at the Council of Ministers for reference; where they differ, the officially published Arabic text prevails. This content is not legal advice.