Amman – The Jordan Medical Association Council has announced that it is taking legal action against a number of insurance companies found to be in violation, referring their cases to the judiciary under Article 19(b)(2) of the Association’s Cooperative Fund Regulation.
In a statement, the Association Council said doctors across the Kingdom had complied with recent decisions issued by the Council, amid union efforts to counter what it described as “pressure attempts and rumors” aimed at undermining professional unity.
The Association said it would continue following up on cases involving its members and using available legal and professional mechanisms to protect their rights against any individual measures they may face.
Insurance Companies’ Union Escalates Dispute
The Jordan Insurance Federation said Sunday that 28 doctors had refused to provide services to insured patients, out of approximately 3,000 doctors.
The Jordan Insurance Federation and the Jordanian Association for Health Insurance announced the cancellation of the accreditation of the 28 doctors within the medical networks of insurance companies, insurance management firms and relevant funds, following their refusal to provide medical services to insured patients.
The two organizations said the doctors affected accounted for less than 1% of the approximately 3,000 doctors included in approved medical networks, adding that the decision had not affected the continuity of medical services for insured patients.
Patients who were unable to receive treatment from the doctors concerned were directed to alternative physicians, where they received the necessary medical services.
The Federation and Association said the decision to cancel accreditation was taken due to what they described as a “breach of contractual obligations,” in accordance with established procedures. They stressed that such measures were intended to ensure that all parties continued fulfilling their obligations to provide medical services to beneficiaries.
The statement said the two organizations planned to announce the names of the doctors who had refused to provide services, in order to alert insured patients not to visit them and avoid being unable to obtain the required treatment. Patients would also be directed to alternative doctors listed within the approved networks.
Continuity of Care Is a Priority
The Federation and Association praised doctors who continued providing medical services to insured patients, stressing that ensuring continuity of healthcare and treatment remained a top priority.
The statement also emphasized the commitment of insurance companies and insurance management firms to providing treatment services to beneficiaries in accordance with approved insurance coverage terms, ensuring continued access to necessary healthcare.
Commenting on the dispute, Secretary of the Jordan Medical Association, Dr. Muzaffar Al-Jalamdeh, said the Association’s decision to suspend dealings with a number of insurance companies had only been taken after all available means and initiatives aimed at ensuring compliance with an agreement signed under the supervision of the Ministry of Health had been exhausted. The agreement was supposed to have entered into force in June 2025.
Speaking to Al-Ghad, he said the Association had contacted the relevant authorities for more than a year in an effort to implement the agreement, but those efforts had been met with denials of commitments, continued delays and obstacles that prevented the required compliance. He said this had negatively affected the organization of the medical sector and the rights of doctors and patients.
Dispute Over Fees and Financial Dues
Al-Jalamdeh said the core of the dispute was the refusal by some insurance companies to implement the provisions of the agreement and the 2024 Doctors’ Fees Schedule published in the Official Gazette.
He said companies continued to impose what he described as unfair and illegal deductions while failing to take doctors’ years of experience into account, resulting in some physicians receiving limited payments for complex medical procedures or examinations.
He added that violations also included delays in paying financial dues beyond the 45-day deadline set under Central Bank regulations, as well as the use of payment methods that did not comply with the direct bank-transfer mechanism.
The dispute has also intensified due to the failure to complete the formation of a joint technical committee responsible for resolving disputes, following the failure of insurance companies to nominate representatives. Al-Jalamdeh also cited the suspension of the Cooperative Fund platform linked to the Hikma system and the electronic tax system.
He stressed that the platform had been established for organized and accurate financial auditing, denying that it was intended to compromise patient privacy or medical confidentiality.
Regarding insurance companies’ concerns that implementing the agreement could increase financial burdens on citizens and raise insurance premiums, Al-Jalamdeh said protecting citizens remained a priority for the Association, but argued that concerns over insurance costs did not justify undermining doctors’ rights.
He said annual insurance premiums had increased by more than 200%, despite the fact that the fees schedule had not actually been implemented, although it had been cited to justify those increases.
He added that the dispute had also affected patients through the rejection of some recommended medical procedures, delays in medical approvals and disruption of treatment procedures.
According to Association estimates, doctors’ fees account for no more than 18% of the total medical bill, he said, noting that the revision of the fees schedule came after it had remained frozen for more than 18 years.
Al-Jalamdeh stressed that the decision to suspend dealings was limited to companies deemed to be in the most serious breach of the agreement, with the aim of correcting their practices and avoiding disruption to the healthcare system.
He emphasized that doctors would continue providing medical care, with all emergency cases and hospital admissions excluded from the suspension and guaranteed to receive care without delay.
He said the Association and the Cooperative Fund Committee remained committed to maintaining the decision until full compliance with the agreement was achieved and binding guarantees were provided for its implementation, while regulating financial relations in a manner that protects the rights of doctors and patients.
Suspension of Dealings Based on Regulations
Meanwhile, Jordan Medical Association spokesperson Dr. Hazem Al-Qaraleh said the Council’s decision to suspend dealings with four insurance companies was based on the 2018 Cooperative Fund Regulation for Doctors, specifically Article 19(b)(1).
The provision prohibits doctors from dealing with any institution that violates the regulation for a period determined by the Association Council based on a recommendation from the relevant committee.
Al-Qaraleh said the decision had, according to the Association’s legal opinion, fulfilled both its formal and substantive requirements, making it valid, effective and binding.
Regarding contracts between doctors and institutions, he explained that Article 21 of the regulation stipulates that contracts concluded before its issuance are deemed automatically cancelled two months after the regulation comes into force, with new contracts to be drawn up in accordance with its provisions.
For contracts concluded after the regulation took effect, Al-Qaraleh said a contract would be considered entirely invalid if it violated the regulation as a whole. If the violation was limited to a specific provision, the contract would remain valid while only the violating clause would be deemed invalid.
The Association therefore maintains that its decision to suspend dealings with insurance companies is grounded in the provisions of the Cooperative Fund Regulation, while emphasizing the need to comply with the agreement and doctors’ fees schedule to regulate relations between physicians and insurance companies and protect the rights of all parties concerned.
Source: Al-Ghad
