Taxes Consolidation Act 1997 section 522

Obligation on authorised insurers

Section 522 requires authorised health insurers to pay practitioners directly when discharging claims for relevant medical expenses, facilitating the deduction of professional services withholding tax (PSWT).

• Where a claim is made under a health insurance contract for relevant medical expenses, the insurer must pay the practitioner who provided the professional services directly, rather than reimbursing the policyholder.
• If the practitioner provided the services as an employee rather than on their own account, the insurer must instead pay the practitioner's employer directly.
• The obligation to pay practitioners directly facilitates the deduction of PSWT from those payments by the health insurer.
• The subscriber or member is treated as having paid the amount that the insurer pays to the practitioner or employer, protecting them from any liability for that amount.