Question:
I work in a government institution where a monthly deduction is made from my salary for health coverage (At-Taghṭiyah Aṣ-Ṣiḥḥīyah). When purchasing medication, if you provide proof of payment, they reimburse 80% or more of the amount paid. Employees with lower incomes receive 100% reimbursement. However, there is an annual limit that cannot be exceeded.
What is the ruling on this? Is it permissible to take the reimbursed amount?
Answer:
Summary:
Government health insurance (At-Ta’mīn Aṣ-Ṣiḥḥī), depending on the insurance contract (‘Aqd At-Ta’mīn), may be either:
- Cooperative Insurance (At-Ta’mīn At-Ta‘āwunī At-Takāfulī) – Permissible (Jā’iz), as it falls under mutual assistance (Ta‘āwun ‘alā Al-Birr).
- Commercial Insurance (At-Ta’mīn At-Tijārī) – Prohibited (Muḥarram), due to elements of uncertainty (Gharar) and gambling (Maysir).
If it is commercial, an employee may only participate if it is mandatory and can only benefit from it up to the amount they contributed in premiums (Aqsāt).
How to Identify if the Insurance is Cooperative or Commercial
One might ask: How can I determine whether my insurance is cooperative or commercial?
To distinguish between them, examine the contract (‘Aqd) between the employees and the institution deducting the contributions:
If the institution acts as a “custodian” (Wakīl or Ajīr) of the premiums and only manages them for mutual coverage of damages among employees, then:
- The compensation or medical expenses are covered collectively by the employees.
- The government institution has no direct financial gain from the funds but merely manages them.
- This is cooperative insurance, and it is permissible (Jā’iz).
If the institution itself provides coverage in exchange for the premiums paid, meaning:
- The institution is responsible for paying medical costs.
- The relationship is between the employee and the institution rather than among the employees themselves.
- This makes it commercial insurance, which is prohibited (Muḥarram) due to its reliance on uncertainty (Gharar) and gambling (Maysir).
What to Do If the Insurance Is Mandatory?
- If the insurance is optional, participation in commercial insurance is not permissible (Ghayr Jā’iz).
- If the insurance is mandatory, then there is no sin (Lā Ḥaraj) on the employee, and they may benefit only up to the amount they contributed in premiums (Aqsāt).
For further details, refer to Fatwa No. 31997.
And Allah knows best.