The Health Service Executive is paying about €2 million per year to a specialist company to assist hospitals in challenging private health insurers over unpaid invoices.Over recent years, public hospitals – those operated directly by the HSE and others run by boards – have written off several million euro in payments billed to insurers in respect of patients. Insurers can decline to pay for several reasons. These include that the patient concerned did not have the appropriate cover, consultants or patients not signing the claim form or the invoice not being submitted within the required time frame.At a hearing of the Dáil Committee of Public Accounts on June 11th, Fianna Fáil TD Paul McAuliffe said sums running into millions were not being recouped from private insurers for public hospitals or hospitals that were largely funded by the public. He said a lot of the difficulties appeared to be administrative. Committee chairman John Brady of Sinn Féin said: “At Tallaght Hospital on its own, nearly €2 million was written off over a five-year period, including just under €1 million in 2022 alone.”The HSE said this week that “a company called Dunraven Point of Care Limited is currently under contract” to provide private health insurance claim-resolution services.“The approximate value of the contract is €2 million annually.”The HSE declined to comment on whether the company was paid on a commission basis or on any associated rates, as this information is commercially sensitive.Dunraven did not reply to approaches from The Irish Times this week.However, an analysis carried out using the public purchase order payment tracker, developed by Fianna Fáil TD Albert Dolan and Matthew Fenlon, shows that in the first quarter of 2026, Dunraven Point of Care Limited received payments for professional fees and financial and accounting services, including debt recovery, of more than €259,000.In a letter to the committee, the Mater hospital in Dublin – which is run by its board – said one of the challenges for hospitals was that once a decision was made by a private health insurance company to reject a claim, “there is very little recourse open to them”. “Recently, the HSE awarded a national contract to a company called Dunraven, whose role it is to review the claims rejected by the insurers and where it is felt there is [a] possibility of recovering some or all of the invoiced amount, a letter of appeal is written to the private health insurer explaining the reasons and asking for a further review of the claim.“The letter of appeal is signed by the primary treating consultant and the qualified doctor employed by a health insurance collection bureau. This has resulted in a number of successful appeals and payments being received by the relevant hospital.”The Mater said that another particular difficulty faced by hospitals was the lack of definition within the legislation as to what procedures were classified as day cases and what should be carried out on an outpatient basis.“It has been the hospital’s experience over the last few years that particular private health insurers are redefining day cases to that of outpatient procedures, thereby excluding such procedures from being invoiced for in line with the Health Act of 1971 and its various amendments. No consultation or engagement was carried out by the private health insurers with the HSE or any hospital and they arbitrarily made the decision”, said the Mater.