Taxes Consolidation Act, 1997 (Number 39 of 1997)
470 Relief for insurance against expenses of illness.
[ITA67 s145(1), (2), (3) and (4); FA80 s19 and Sch1 PtIII par1; FA96 s7 and s132(1) and Sch5 PtI par1(4)]
(1) In this section—
“appropriate percentage”, in relation to a year of assessment, means a percentage equal to the standard rate of tax for that year;
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“authorised insurer” means any undertaking entered in The Register of Health Benefits Undertakings, lawfully carrying on such business of insurance referred to in the definition of “relevant contract” but, in relation to an individual, also means any undertaking authorised pursuant to Council Directive No. 73/239/EEC of 24 July 19731, Council Directive No. 88/357/EEC of 22 June 19882, and Council Directive No. 92/49/EEC of 18 June 19923, where a relevant contract was effected with the individual when the individual was not resident in the State but was resident in another Member State of the European Communities;
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“authorised insurer” means—
(a) any undertaking entered in the Register of Health Benefits Undertakings, lawfully carrying on such business of medical insurance referred to in paragraph (a) of the definition of “relevant contract” but, in relation to an individual, also means any undertaking authorised pursuant to Council Directive No. 73/239/EEC of 24 July 19731, Council Directive No. 88/357/EEC of 22 June 19882, and Council Directive No. 92/49/EEC of 18 June 19923, where such a contract was effected with the individual when the individual was not resident in the State but was resident in another Member State of the European Communities, or
(b) (i) any undertaking standing authorised under—
(I) the European Communities (Non-Life Insurance) Framework Regulations 1994 (S.I. No. 359 of 1994),
(II) the European Communities (Non-Life Insurance) Regulations 1976 (S.I. No. 115 of 1976), or
(III) the European Communities (Non-Life Insurance) (Amendment) (No. 2) Regulations 1991 (S.I. No. 142 of 1991),
or
(ii) any undertaking authorised by the authority charged by law with the duty of supervising the activities of insurance undertakings in a Member State of the European Communities other than the State in accordance with Article 6 of Council Directive No. 73/239/EEC of 24 July 1973 as inserted by Article 4 of Council Directive No. 92/49/EEC of 18 June 1992,
lawfully carrying on such business of dental insurance referred to in paragraph (b) of the definition of “relevant contract”;
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“child” means an individual under the age of 18 years or, if over the age of 18 years and under the age of 23 years, who is receiving full-time education and in respect of whom the payment under a relevant contract has been reduced in accordance with paragraph (a)(ii) or (b)(i) of section 7(5) of the Health Insurance Act 1994;
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“child” means an individual under the age of 21 years in respect of whom the payment under a relevant contract has been reduced in accordance with paragraph (a)(ii) or (b)(i)(I) of section 7(5) of the Health Insurance Act 1994;
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“relevant contract”, in relation to an individual, means a contract of insurance which provides specifically, whether in conjunction with other benefits or not, for the reimbursement or discharge, in whole or in part, of actual medical, surgical or nursing expenses (including the cost of maintenance at a hospital, nursing home or sanatorium) resulting from sickness of or accident to—
(a) the individual,
(b) the spouse of the individual, or
(c) the children or other dependants of the individual or of the spouse of the individual.
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“relevant contract”, in relation to an individual, means a contract of insurance which provides specifically, whether in conjunction with other benefits or not, for the reimbursement or discharge, in whole or in part, of actual health expenses (within the meaning of section 469) of—
(a) the individual,
(b) the spouse of the individual, or
(c) the children or other dependants of the individual or of the spouse of the individual;
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“relevant contract” means a contract of insurance which, in relation to an individual, the [9]>spouse<[9][9]>spouse or civil partner<[9] of the individual, or the children or other dependants of the individual or of the [9]>spouse<[9][9]>spouse or civil partner<[9] of the individual, provides specifically, whether in conjuction with other benefits or not, for the reimbursement or discharge, in whole or in part, of—
(a) actual health expenses (within the meaning of section 469), being a contract of medical insurance, or
(b) dental expenses other than expenses in respect of routine dental treatment (within the meaning of section 469), being a contract of dental insurance;
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“relevant contract” means a contract of insurance which provides specifically, whether in conjunction with other benefits or not, for the reimbursement or discharge, in whole or in part, of—
(a) actual health expenses (within the meaning of section 469), being a contract of medical insurance, or
(b) dental expenses other than expenses in respect of routine dental treatment (within the meaning of section 469), being a contract of dental insurance;
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“relievable amount”, in relation to a payment to an authorised insurer under a relevant contract, means—
(a) where the payment covers no benefits other than such reimbursement or discharge as is referred to in the definition of “relevant contract”, an amount equal to the full amount of the payment [7]>reduced by the amount of credit due (if any) under section 470B(4)<[7] [11]>and credit due (if any) under a risk equalisation scheme (within the meaning of the Health Insurance Act 1994)<[11], or
(b) where the payment covers benefits other than such reimbursement or discharge as is referred to in that definition, an amount equal to so much of the payment as is referable to such reimbursement or discharge [8]>reduced by the amount of credit due (if any) under section 470B(4)<[8] [11]>and credit due (if any) under a risk equalisation scheme (within the meaning of the Health Insurance Act 1994)<[11].
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“relievable amount”, in relation to a payment to an authorised insurer under a relevant contract, means—
(a) where the payment covers no benefits other than such reimbursement or discharge as is referred to in the definition of “relevant contract”, an amount equal to the full amount of the payment reduced by the amount of credit due (if any) under section 470B(4) and credit due (if any) under a risk equalisation scheme (within the meaning of the Health Insurance Act 1994), or
(b) where the payment covers benefits other than such reimbursement or discharge as is referred to in that definition, an amount equal to so much of the payment as is referable to such reimbursement or discharge reduced by the amount of credit due (if any) under section 470B(4) and credit due (if any) under a risk equalisation scheme (within the meaning of the Health Insurance Act 1994),
provided that in respect of a relevant contract renewed or entered into on or after 16 October 2013 the relievable amount in respect of any payment made under a relevant contract, in respect of any 12 month period covered by that contract, shall not exceed the aggregate of—
(i) the lesser of the relievable amount attributable to each individual, other than a child, to whom the relevant contract relates, or €1,000 in respect of each individual, and
(ii) the lesser of the relievable amount attributable to each child to whom the relevant contract relates, or €500 in respect of each child,
and where the contract is for a period of less than 12 months or being for a period of 12 months is terminated before the end of that period, the relievable amount shall be reduced proportionately.
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(2) Where an individual for a year of assessment proves that in the year preceding the year of assessment—
(a) the individual, or
(b) if the individual is a married person assessed to tax in accordance with section 1017, the individual’s spouse,
has made a payment to an authorised insurer under a relevant contract, then, the income tax to be charged on the individual if the individual made the payment, or on the individual’s spouse if the individual’s spouse made the payment, for the year of assessment, other than in accordance with section 16(2), shall be reduced by an amount which is the lesser of—
(i) (I) where the payment covers no benefits other than such reimbursement or discharge as is referred to in the definition of “relevant contract”, an amount equal to the appropriate percentage of the full amount of the payment, or
(II) where the payment covers benefits other than such reimbursement or discharge as is referred to in the definition of “relevant contract”, an amount equal to the appropriate percentage of so much of the payment as is referable to such reimbursement or discharge,
and
(ii) the amount which reduces that income tax to nil.
(3) Where the income tax reduction of one of the spouses is ascertained in accordance with subsection (2), then—
(a) if there is no income tax to be charged on the spouse for the year of assessment, other than in accordance with section 16(2), in relation to which relief under subsection (2) may be given, the relief may be given in relation to income tax to be charged on the other spouse for that year, other than in accordance with section 16(2), and
(b) if the amount so ascertained exceeds the income tax to be charged on the spouse for the year of assessment, other than in accordance with section 16(2), the excess may be used to reduce the income tax to be charged on the other spouse for that year, other than in accordance with section 16(2).
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(2) Subject to subsection (3), where for a year of assessment—
(a) an individual, or
(b) if the individual is [10]>a married person assessed to tax in accordance with section 1017, the individual’s spouse<[10][10]>a married person assessed to tax in accordance with section 1017, or a civil partner assessed to tax in accordance with section 1031C, the individual’s spouse or civil partner, as the case may be,<[10]
has made a payment to an authorised insurer under a relevant contract, then, the income tax to be charged on the individual for the year of assessment, other than in accordance with section 16(2), shall be reduced by an amount which is the lesser of—
(i) an amount equal to the appropriate percentage of the relievable amount in relation to the payment, and
(ii) the amount which reduces that income tax to nil.
(3) (a) Where, on or after 6 April 2001, an individual makes a payment to an authorised insurer in respect of a premium due on or after that date under a relevant contract for which relief is due under subsection (2), the individual shall be entitled to deduct and retain out of it an amount equal to the appropriate percentage, for the year of assessment in which the payment is due, of the relievable amount in relation to the payment.
(b) An authorised insurer to which a payment referred to in paragraph (a) is made—
(i) shall accept the amount paid after deduction in discharge of the individual’s liability to the same extent as if the deduction had not been made, and
(ii) may, on making a claim in accordance with regulations, recover from the Revenue Commissioners an amount equal to the amount deducted.
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(4) Where relief is given under this section, no relief or deduction under any other provision of the Income Tax Acts shall be given or allowed in respect of the payment or part of a payment, as the case may be.
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(5) (a) The Revenue Commissioners shall make regulations providing generally as to administration of this section and those regulations may, in particular and without prejudice to the generality of the foregoing, include provision—
(i) that a claim under subsection (3)(b)(ii) by an authorised insurer, which has registered with the Revenue Commissioners for the purposes of making such a claim, shall—
(I) be made in such form and manner,
(II) be made at such time, and
(III) be accompanied by such documents,
as provided for in the regulations;
(ii) for the making of annual information returns by authorised insurers, in such form (including electronic form) and manner as may be prescribed, and containing specified details in relation to—
(I) each individual making payments to such insurers under relevant contracts in a year of assessment,
(II) the total amount of premiums paid under a relevant contract by that individual in the year of assessment, and
(III) the total amount deducted by that individual under subsection (3)(a);
and
(iii) for the furnishing of information to the Revenue Commissioners for the purposes of the regulations.
(b) Every regulation made under this section shall be laid before Dáil Éireann as soon as may be after it is made and, if a resolution annulling the regulation is passed by Dáil Éireann within the next 21 days on which Dáil Éireann has sat after the regulation is laid before it, the regulation shall be annulled accordingly, but without prejudice to the validity of anything previously done thereunder.
(6) (a) Where any amount is paid to an authorised insurer by the Revenue Commissioners as an amount recoverable by virtue of subsection (3)(b)(ii) but is an amount to which that authorised insurer is not entitled, that amount shall be repaid by the authorised insurer.
(b) There shall be made such assessments, adjustments or set-offs as may be required for securing repayment of the amount referred to in paragraph (a) and the provisions of this Act relating to the assessment, collection and recovery of income tax shall, in so far as they are applicable and with necessary modification, apply in relation to the recovery of such amount.
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Footnotes
1 O.J. No. L228 of 16.8.1973, p.3.
2 O.J. No. L172 of 4.7.1988, p.1.
3 O.J. No. L228 of 11.8.1992, p.1.
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[1]
Substituted by FA01 s19(1)(a)(i). Applies as respects the year of assessment 2001 and subsequent years of assessment.
[2]
Inserted by FA01 s19(1)(a)(ii). Applies as respects the year of assessment 2001 and subsequent years of assessment.
[3]
Substituted by FA01 s19(1)(b). Applies as respects the year of assessment 2001 and subsequent years of assessment.
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Inserted by FA01 s19(1)(c). Applies as respects the year of assessment 2001 and subsequent years of assessment.
[11]
Inserted by FA13 s15. Applies as respects the year of assessment 2013 and each subsequent year of assessment.
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Inserted by F(No.2)A13 s8(1)(a). Applies in respect of relevant contracts (within the meaning of section 470) entered into or renewed on or after 16 October 2013.
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Substituted by F(No.2)A13 s8(1)(b). Applies in respect of relevant contracts (within the meaning of section 470) entered into or renewed on or after 16 October 2013.
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Substituted by F(No.2)A13 s8(1)(c). Applies in respect of relevant contracts (within the meaning of section 470) entered into or renewed on or after 16 October 2013.