904E Power of inspection: claims by authorised insurers

Summary

Under the tax relief at source (TRS) arrangements individuals deduct a percentage equal to the standard rate when making premium payments to medical insurers. In the case of premium payments to which section 470B applies (premiums which qualify for the agerelated tax credit in respect of insured persons aged 50 years or older), individuals also deduct an amount equivalent to the age-related tax credit(s) due in respect of the premium. The insurers, in turn, claim repayment of equivalent amounts from the Revenue Commissioners.

This section enables the Revenue Commissioners to audit claims for repayments by medical insurers to ensure that these are correct. To ensure that the relief at source arrangements are being complied with, the Revenue Commissioners can check procedures relating to the vouching of the claims and they are also permitted to examine, on a sample basis, underlying records to ensure that the procedures are both adequate and observed and that claims from individuals are valid.

Details

(1) “authorised insurer” is defined by reference to the meaning of that term in section 470(1) in respect of claims made under section 470(3)(b)(ii), and by reference to section 470B(1) in respect of claims made under section 470B(6)(b)(ii).

“authorised officer” means a person authorised in writing by the Revenue Commissioners to exercise the powers conferred by this section.

(2) An authorised officer may enter, at all reasonable times, any premises or place of business of a medical insurer to audit claims for repayment made by that insurer under section 470(3)(b)(ii) or section 470B(6)(b)(ii) of sums deducted by individuals under the TRS arrangements.

(3) The audit procedures can include—

• examination of the procedures adopted by the medical insurer relating to the vouching of claims,
• checking a sample of the cases in respect of which a claim has been made to determine whether those procedures have been observed and are adequate.

(4) The authorised officer can require the insurer or its employees to give information, explanations and particulars and to afford reasonable assistance in carrying out his or her duties.

(5) The authorised officer is to produce proof of authorisation on request.

(6) An employee of a medical insurer is liable to a penalty of €1,265 for failure to comply with the requirements of an authorised officer in the exercise or performance of his or her powers or duties.

(7) Where the medical insurer fails to comply, the penalty is €19,045 with a further penalty of €2,535 for each day that the failure continues.

Relevant Date: Finance Act 2019