A distortion to Law 87-01 in terms of coverage traffic accidents drags a cost of RD$6,541.70 million accumulated in ten years, which is a flagrant violation because those funds have been taken from the Family Health Insurance (SFS) to finance the responsibility of third parties in these events, he affirmed Arismendy Diaz Santanaeconomist and expert in social security.
This situation occurs, according to their statements, because the governments of the day have been afraid to apply the law in its fair dimension, and in return they harm affiliates when resources that should be invested in other types of medical coverage are diverted or directed to the pension sector.
In his opinion, it makes no sense that those responsible for the collisions that leave balances of deaths and injuries do not cover the damages, but rather that the workers finance them through the SFS.
In that sense, he said that it is the cause of the damage that has to cover the consequences, because otherwise the system does not work.
“The Government was afraid of that, Leonel’s and Danilo’s, and this one has played along…. At first they said that raising the rates on the vehicles would cause problems, and then they began to cover it, to send a little money.
“But since that began to grow, and the Dominican Republic is one of the countries with the most deaths from traffic accidents, then here comes a flagrant violation of the law, because they are taking money from the Family Health Insurance to finance medical care for accidents. traffic”.
Díaz Santana explains that while these funds are allocated to this type of event, they deny members protection for coverage of certain medications, or more access to health services for pensioners.
The transitory FONOMAT
Law 87-01 on the Dominican Social Security System It establishes, in article 119, that the SFS does not cover medical care for traffic accidents, because they are covered in Law 4117 on Compulsory Motor Vehicle Insurance.
Paragraph I of Law 87-01 establishes that “The costs of care derived from traffic accidents will be charged to the mandatory motor vehicle insurance or, failing that, to the person responsible for it.”
Paragraph II states that “The National Social Security Council will study and regulate the creation and operation of a National Accident Fund”.
In August 2007, the National Social Security Council issued resolution 165-04, which temporarily approved the Regulations of the National Fund for Medical Attention for Traffic Accidents (FONAMAT).
In 2013, this resolution was modified by 332-03, which provides, among other aspects, that Health Risk Insurers and Health Service Providers are obliged to offer the medical services included in the FONOMAT transitional, to affiliates of the contributory and subsidized regimes.
