Health Insurance Act 1994

F127[Powers of authorised officers.

18F

18F.F128[(1) (a) The powers conferred by this section may be exercised in respect of any person to whom this section applies for the purposes of—

(i) securing the enforcement of the provisions of this Act (including any regulations made under this Act), or

(ii) enabling or assisting the Minister or the Authority to perform any of their respective functions under this Act.

(b) Subject to subsection (6), the following are persons to whom this section applies (whether they are within or outside the State):

(i) a registered undertaking;

(ii) a former registered undertaking;

(iii) a person who has applied for registration in the Register;

(iv) a person whom the Authority or an authorised officer reasonably believes is or has been acting as, or claiming or holding itself out to be, a registered undertaking;

(v) a person who is or has been, or whom the Authority or an authorised officer reasonably believes is or has been, without being registered in the Register, effecting, or offering to effect, health insurance contracts in respect of which the person is required to be a registered undertaking;

(vi) a related undertaking of any of the persons referred to in any of subparagraphs (i) to (v);

(vii) a person whom the Authority or an authorised officer reasonably believes may possess or have control of information about a health insurance contract;

(viii) any other person whom the Authority or an authorised officer reasonably believes may possess information about a person referred to in any of subparagraphs (i) to (vii);

(ix) a person who is, in relation to a person referred to in any of subparagraphs (i) to (viii), a person specified in paragraph (c);

(x) a person who is or has been an officer or employee or agent of a person referred to in any of subparagraphs (i) to (ix) or is, in relation to a person who is or has been such an officer, employee or agent, a person specified in paragraph (c).

(c) The persons referred to in subsection (1)(b)(ix) and (x) are—

(i) an administrator within the meaning of section 1 (1) of the Insurance (No. 2) Act 1983 ,

(ii) an examiner, liquidator, receiver or official assignee, and

(iii) a person with functions corresponding to those of any of the persons referred to in subparagraph (i) or (ii) under the law of a state other than the State.]

(2) An authorised officer may do all or any of the following:

(a) subject to subsection (3), at all reasonable times enter any premises, at which there are reasonable grounds for believing that any books, records or other documents in relation to the issue of any health insurance contract, or in relation to the acceptance of any premium in respect of a health insurance contract, are kept, and search and inspect the premises and such books, records or other documents on the premises;

(b) secure for later inspection any premises or any part of a premises in which books, records or other documents are kept or there are reasonable grounds for believing that such books, records or other documents are kept;

(c) require any person to whom this section applies F129[] to produce to the authorised officer such books, records or other documents and in the case of information in a non-legible form to reproduce it in a legible form or to give to the officer such information or explanation as the officer may reasonably require in relation to any entries in such books, records or other documents;

(d) inspect and take copies of or extracts from, or remove for a reasonable period for further examination, any books, records, F130[data (including data that constitutes personal data)] or other documents in whatever form kept (including, in the case of information in a non-legible form, a copy of or extract from such information in a permanent legible form) which the officer finds or which is produced to the officer in the course of inspection;

(e) require any person to whom this section applies F129[] to give to the authorised officer such information as the officer may reasonably require in relation to any entries in such books, records or other documents;

(f) require any person to whom this section applies to give to the authorised officer any information which the authorised officer may require in regard to the business or activity concerned or in regard to the persons carrying on such business or activity or employed in connection therewith;

(g) require any person by whom or on whose behalf data equipment is or has been used or any person having charge of, or otherwise concerned with the operation of, the data equipment or any associated apparatus or material, to afford the authorised officer reasonable assistance in relation thereto;

(h) summon, at any reasonable time, any other person employed in connection with the business or activity concerned to give to the authorised officer any information which the officer may reasonably require in regard to such business or activity and to produce to the authorised officer any books, records or other documents which are in that person’s power or control;

(i) require any person employed in the premises concerned to prepare a report on aspects of the business specified by the authorised officer or activities of a person to whom this section applies or to explain entries in any books, records, documents or other materials furnished.

(3) An authorised officer shall not, other than with the consent of the occupier, enter a private dwelling unless he or she has obtained a warrant issued by a judge of the District Court under subsection (8) authorising such entry.

(4) A person who has in his or her power, possession or procurement any books, records or other documents referred to in subsection (2) shall—

(a) produce them at the request of an authorised officer and permit the authorised officer to inspect and take copies of, or extracts from, them,

(b) at the request of an authorised officer, give any information which may be reasonably required with regard to them, and

(c) give such other assistance and information to an authorised officer as is reasonable in the circumstances.

(5) Where any person from whom production of a book, record or other document is required claims a lien thereon the production of it shall be without prejudice to the lien.

(6) The duty to produce or provide any information, document, material or explanation extends to F128[any person (not being a person to whom this section applies)] who appears to the Minister, the Authority or the authorised officer to have the information, document, material or explanation in his or her possession or under his or her control.

(7) An authorised officer, where he or she considers it necessary, may be accompanied by a member of the Garda Síochána when performing any powers conferred on an authorised officer by this Act.

(8) If a judge of the District Court is satisfied on the sworn information of an authorised officer that there are reasonable grounds for suspecting that there is information required by an authorised officer under this section held on any premises or any part of any premises, the judge may issue a warrant authorising an authorised officer, accompanied by other authorised officers or by a member of the Garda Síochána, at any time or times within one month from the date of issue of the warrant, on production of the warrant if so requested, to enter the premises, if need be by reasonable force, and exercise all or any of the powers conferred on an authorised officer under this section.

(9) A person shall not—

(a) obstruct or impede an authorised officer in the exercise of a power under this section,

(b) give to an authorised officer information which the person knows is false or misleading, or

(c) without reasonable excuse, fail to comply with a request or requirement made by an authorised officer under this section.

(10) (a) If any officer, employee, shareholder or agent of a person to whom this section applies refuses to produce to an authorised officer when requested to do so any book or document which it is his or her duty under this section to produce, or refuses to cooperate with an authorised officer when required to do so, or refuses to answer any question put to him or her by an authorised officer with respect to the affairs of the person to whom this section applies, the authorised officer may certify the refusal under his or her hand to the High Court.

(b) Where a refusal is certified to the High Court, the High Court may enquire into the case and, after hearing any witnesses who may be produced against or on behalf of the officer, employee, shareholder or agent of the person to whom this section applies and any statement which may be offered in defence, make any order or direction as it thinks fit.

(c) An order or direction made under paragraph (b) may include a direction to the person concerned to attend or re-attend before the authorised officer or produce particular books or documents or answer a particular question put to him or her by the authorised officer, or a direction that the person concerned need not produce a particular book or document or answer a particular question put to him or her by the authorised officer.

(11) A person shall not falsely represent himself or herself as an authorised officer.

F131[(11A) An authorised officer may require a person to provide him or her with the person’s name and address where—

(a) the authorised officer has reasonable grounds for believing that the person—

(i) is committing or has committed an offence under this Act, or

(ii) has deliberately concealed or destroyed evidence, or is deliberately concealing or destroying evidence, or is likely to deliberately conceal or destroy evidence, of such an offence,

or

(b) the authorised officer has reasonable grounds for requiring such information for the purpose of applying for a warrant under subsection (8).]

(12) In this section—

"agent", in relation to a person to whom this section applies, includes past as well as present agents, and includes its bankers, accountants, solicitors, auditors and its financial and other advisers, whether or not those persons are officers or persons to whom this section applies;

F132["Data Protection Regulation" means Regulation (EU) 2016/679 of the European Parliament and of the Council of 27 April 201618 on the protection of natural persons with regard to the processing of personal data and on the free movement of such data, and repealing Directive 95/46/EC (General Data Protection Regulation);]

F128["person to whom this section applies" shall be construed in accordance with subsection (1)(b) and (c);]]

F132["personal data" means personal data within the meaning of—

(a) the Data Protection Regulation, or

(b) Part 5 of the Data Protection Act F128[2018;]]

F131["related undertaking", in relation to a person (in this definition referred to as the "first-mentioned person"), means—

(a) if the first-mentioned person is a company, another company that is related within the meaning of section 2 (10) of the Companies Act 2014,

(b) a partnership of which the first-mentioned person is a member,

(c) if the business of the first-mentioned person and another person have been so carried on that the separate business of each of them, or a substantial part thereof, is not readily identifiable, that other person,

(d) if the decision as to how and by whom the business of the first‑mentioned person and another person shall be managed can be made either by the same person or by the same group of persons acting in concert, that other person,

(e) a person who performs a specific and limited purpose by or in connection with the business of the first-mentioned person, or

(f) if provision is required to be made for the first-mentioned person and another person in any consolidated accounts compiled in accordance with the Seventh Council Directive 83/349/EEC of 13 June 19831, that other person.]

Annotations

Amendments:

F126

Substituted (1.01.2023) by Health Insurance (Amendment) Act 2022 (49/2022), s. 2, commenced as per s. 8(2)(a).

F127

Inserted (26.12.2012) by Health Insurance (Amendment) Act 2012 (45/2012), s. 17, commenced on enactment.

F128

Substituted (1.01.2023) by Health Insurance (Amendment) Act 2022 (49/2022), s. 5(a), (c), (e)(i), (ii), commenced as per s. 8(2)(b).

F129

Deleted (1.01.2023) by Health Insurance (Amendment) Act 2022 (49/2022), s. 5(b), commenced as per s. 8(2)(b).

F130

Substituted (25.05.2018) by Data Protection Act 2018 (7/2018), s. 180(a), S.I. No. 174 of 2018.

F131

Inserted (1.01.2023) by Health Insurance (Amendment) Act 2022 (49/2022), s. 5(d), (e)(iii), commenced as per s. 8(2)(b).

F132

Inserted (25.05.2018) by Data Protection Act 2018 (7/2018), s. 180(b), S.I. No. 174 of 2018.