SINT MAARTEN (GREAT BAY) - The Ombudsman has launched a systemic investigation into the administrative practices of Social and Health Insurance (SZV), following a complaint involving the suspension of medical treatment abroad, the forced repatriation of an insured person, and the imposition of financial consequences without a formal written administrative decision.
The investigation has been launched at the level of the functionally responsible government body which is the Minister of VSA, this escalation to the level of the Minister follows the lack of cooperation of SZV to queries of the Ombudsman surrounding not only the case but its laws and policies.
The investigation originates from a complaint involving an insured person who had been referred abroad for medical treatment. The treatment was reportedly suspended and the patient repatriated before the completion of scheduled procedures.
SZV indicated that the measure was based on an alleged violation of its Regulation on the Duties, Rights, and Responsibilities of the Insured during Medical Referral Abroad (RDIRA). However, despite repeated requests, no formal written decision outlining the factual basis, legal grounds, or available legal remedies was issued.
Following the complaint lodged with the Bureau Ombudsman in December 2025, the Ombudsman formally requested information from SZV, including clarification of the legal basis for its actions and access to alleged evidence that supposedly justified the measures taken. Since that time, SZV's responses have been characterized by significant inconsistencies and procedural barriers.
The Ombudsman notes that under Article 3 of the Landsverordening administratieve rechtspraak (LAR), measures such as suspending medical treatment, repatriating an insured person, or imposing financial obligations constitute administrative decisions that must be issued in writing.
The Ombudsman warns that allowing public bodies to impose measures with legal and financial consequences without formal written decisions undermines fundamental principles of good governance and the right of citizens to seek judicial review.
Although the investigation originates from an individual complaint, the Ombudsman notes that the issues raised may indicate broader structural concerns in the administrative practices applied in cases involving medical referrals abroad.
Persons who have experienced similar issues with SZV regarding medical treatment abroad, repatriation, or unresolved administrative decisions are encouraged to contact the Bureau Ombudsman at E.C. Richardson Street 13, by telephone at 542-1243, or via email at info@ombudsman.sx.
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