An incident has occurred, of any kind; accidental or catastrophic or any other factor. Financial damage has been incurred and this financial loss or cost for treating an illness or solving a spinal problem and not having this cost can lead to destruction and significant loss and damage. This is where a modern structure comes to help. “Insurance” is a way to assist the injured. Of any kind. Assistance that can only help with physical damage.

The word “insurance” is familiar to us. For years, we have seen advertisements for various insurance companies in the media, on the walls of cities and neighborhoods. There are different types of insurance with various uses and applications available to us, and at first glance, this wide range of options may seem like a stroke of luck for insurance seekers. However, the issue that both the insurance seeker and the individual face is not just about insurance being a means of creating security and peace of mind, but also as an industry. An industry that, due to its nature, has costs and benefits, competition, and its own bureaucratic processes.

Every search that is done, we are not only faced with the word “insurance”; what comes to hand is the insurance industry. And it is considered a way to reduce medical expenses for individuals, companies, and any legal entity that encounters risk, difficulty, or problem and seeks a solution.

Article 44 of the Constitution of the Islamic Republic of Iran recognizes insurance as part of the division of economic sectors belonging to the government.

This means that logically, the main supporter of the insurance issue, as a human right in Iranian society, should be the government. Article 29 of the Constitution of the Islamic Republic also states: “Access to social security in terms of retirement, unemployment, old age, disability, single parenthood, staying on the job, accidents and disasters, the need for health and medical services and care, etc. is a universal right. The government is obligated to provide services and financial support for each individual in the country, according to the laws, from public revenues and revenues obtained through public participation.”

Based on this principle, access to social security, medical care, and insurance has been determined as a universal right. A right that all Iranian citizens should equally benefit from.

Furthermore, according to Article 21 of the Constitution of the Islamic Republic of Iran, the establishment of special insurance for the elderly and women without a guardian is considered a right for Iranian women.

Furthermore, social security, having insurance, and insurance support have been considered as a human right, which is necessary for the survival of human society in the present era and the preservation of human values, fundamental rights, and dignity.

Based on the provisions of the Constitution of the Islamic Republic of Iran and relevant laws such as the Social Security Law (which was passed in 1975), insurance and social security have been considered as human and citizen rights. These rights should be provided through government organizations such as the “Social Security Organization” in Iran. This organization, according to its own law, justifies its existence by stating that its purpose is “to implement and expand various social insurance schemes and establish a coordinated and proportional system in line with social security programs, as well as to concentrate and invest the funds and revenues specified in the Social Security Law and to manage and benefit from the funds and reserves.” This independent organization, called the “Social Security Organization”, is affiliated with the Ministry of Health, Treatment, and Medical Education, and is referred to as the “Organization” in this law. It has legal personality and financial and administrative independence, and its affairs will be managed solely according to its articles of association, which will be approved

However, the everyday experience of people in Iran shows something different. Protests regarding insurance issues in Iran are heard frequently. Despite having supplementary insurances and various types of insurance, medical expenses are not covered. The issue is so chaotic that Seyed Mohammad Mehdi Alavi, a senior manager of the Entrepreneur Insurance and an activist in the insurance industry in 1392, explained the country’s insurance conditions in an interview with the media, stating that “the unfavorable economic conditions in the country over the past 10 years have caused a recession in the insurance industry.” He also added in the interview: “If the insurance industry is not in a desirable state, it will have a negative impact on the economic conditions. Similarly, if the economic sectors of the country do not request insurance, the insurance conditions will be inadequate, and if insurance companies are unable to issue insurance policies for industries, we will face problems.”

Alavi explains the insurance situation in Iran, stating that due to the past 10 years’ conditions and the economic situation, “we do not have a position in the insurance industry in the world and the region.”

5 months ago, the former head of the Central Insurance Company, in a conversation with the central news unit, stated, “By overcoming the barriers of insurance sanctions that are completely against international and global norms, we can turn this threat into an opportunity for the development of the domestic insurance industry; a very valuable and almost endless achievement.” He claims that the Iranian insurance industry has a superior position in the region. However, this statement contradicts the remarks of senior insurance activists who are directly involved in the issue, and it clearly reveals the attempt by the country’s top insurance managers to cover up the chaotic state of the insurance industry. This is something that can easily be seen through the experience of living in the country.

Another important point in this regard is that according to Mohammad Hossein Ghorbani, the spokesperson of the Health and Treatment Commission of the Parliament, in an interview with Fars News Agency, Iran’s health ranking among 190 countries in the world is 117.

But let’s examine the insurance situation in one of our neighboring countries. Afghanistan; our eastern neighbor that has endured about three decades of war and is currently awaiting the results of their presidential election. A neighbor whose citizens have been present in Iran for many years as laborers and workers, and a nation that has suffered greatly. Let’s see what the insurance situation is like in Afghanistan…

The situation of insurance and healthcare services in Afghanistan is not suitable. According to statistics and an article in an Afghan newspaper, 38% of the population still do not have access to health services, which means that this 38% do not have access to public clinics and doctors, nor to medication and treatment, and the issue of having private doctors and insurance systems is foreign to the people of Afghanistan.

But the most important issue for Afghans is the issue of insurance culture; people who have gone through long wars are distrustful of the government and all government services, including insurance. The Afghan Voice Agency (AVA) writes in this regard: “What is certain and evident is that many of our compatriots do not even know what insurance is and what benefits it can have for them, which is of course due to various reasons, including the very limited activities of insurance companies and the lack of widespread availability of their services. Currently, in Afghanistan, out of 167 types of insurance services available in global markets, only 4 are used, which according to country officials include commercial, motor, health, and accident insurance.”

In fact, the main issue in Afghanistan is its cultural problem. However, there is a trend towards improvement. The intelligence agency reports that a one-day conference on cultural insurance was held in the ancient city of Herat in November 2011. This is one of the many conferences that have been held in recent years in this country on this topic. A report on another conference on this topic was also published in July 2012. Surely, if more research is done, more news will be found on this matter, which shows that Afghanistan is on the path towards improvement. Despite years of war, tragedy, and disaster, Afghanistan is moving towards improving its situation.

The first time that the Afghan Insurance Company was established in this country was in 1364. Currently, this company is owned by the government, with approximately 60% of its shares belonging to the Ministry of Finance and the remaining shares owned by Qaragol Company, Afghan National Bank, Afghan Textile Company, and Pashtani Commercial Bank. An examination of the company’s activities shows that the majority of its operations (around 92%) are in the field of third-party insurance.

After the establishment of the new government in Afghanistan, a new insurance administration was formed and the path for the insurance industry in Afghanistan became smoother. Today, there are 4 active insurance companies in this country and the government is seeking to increase participation in the insurance industry.

In the United Arab Emirates, another neighbor of Iran, according to the 2013 insurance report by multinational company Capgemini, alongside 40 other countries such as the United States and England, they hold 95% of the world’s insurance market. In fact, the UAE competes with these countries in this field and each sheikh has their own separate access to these services and has their own modern structure. In the UAE, only 30% of medical expenses are paid for by the people.

The issue of our western neighbor, Iraq, is similar to the story of Afghanistan. A country that has been struggling with years of dictatorship, war, poverty, and a focus on oil rather than food, trying to move towards improvement. According to the Teacher’s Insurance Agency, in the year 1389, Ali Akbar Zali, the manager of one of the branches of this insurance in Iraq, speaks of the lack of insurance knowledge among the people and introduces the Iraqi market as a virgin market for insurance companies.

Iraqi authorities welcomed the presence of foreign insurance companies with large financial assets at a conference held last summer aimed at attracting investment for the insurance sector in Iraq. They saw their presence as a catalyst for the growth of the insurance industry in Iraq. It should be noted that Iraq is among the advanced countries in the insurance industry and has had this industry since 1950. In 1964, a law was passed to link Iraqi insurance organizations with the economic organizations of the country. Relevant authorities are striving for the growth of this sector in the ongoing economic and industrial development of these countries.

The World Health Organization also reports on Turkey’s growth in the past ten years in the field of insurance and social security in the health sector. This situation is also based on government policies towards improvement. The insurance market in Turkey is considered a dynamic market because it is constantly growing and updating, and as a result, this market is constantly changing, evolving, and renovating itself.

In Turkey, the healthcare system follows a model that many developed countries also adhere to; the payers are usually the government or insurance funds, financing is based on income tax, and the type of payment to service providers is through a budget and fixed salaries. The ownership of healthcare facilities belongs to these payers (local government, central government, and public insurance). In fact, service provision, financing, planning, evaluation, and management are all the responsibility of the government, and universal coverage of services is easily achievable in this model. (4).

However, among the countries in the Middle East, Saudi Arabia seems to have a special situation. Despite having the largest local population, insurance penetration in the local market of this country is only 0.8%. Saudi Arabia also suffers from a lack of interest from insurance policyholders, and the news indicates the severity of the situation of insurance companies and the state of insurance services in this country. Based on World Bank statistics, Saudi Arabia’s health expenditure per capita is $795, which is significantly higher than Turkey’s $664.6 per person (in 2012). However, the climate, tribal composition, and highly traditional society of Saudi Arabia reduce insurance penetration. This lack of insurance penetration also means a lack of access to modern medicine, new medical centers, and medical science in this country. In these types of societies, instead of modern medicine, traditional medicine, herbal medicine, and local traditional doctors are responsible for the health of the people, who have been working tirelessly for years. The issue

But our eastern neighbor, Pakistan, which has recently been in the spotlight due to border issues, can only be described as having a per capita health expenditure of $39.4 in 2012. (6) This number, along with the deeply traditional and religious society of Pakistan and its tumultuous history since gaining independence, is a result of religious tensions with Hindus (by Muhammad Ali Jinnah, Iqbal Lahore, and the Muslim League) and ongoing sectarian violence, indicating a dire state of healthcare and, consequently, the issue of health insurance as a guarantor of health in this country.

What is understandable from the situation of our neighboring countries, except for Pakistan, is that all of them, both based on their current situation and the trend of growth in insurance status, are in a better situation than Iran. Of course, all of these except for Saudi Arabia have a special social and governmental structure, which directly affects the society’s attitude towards insurance. It is necessary to mention about Iraq and Afghanistan that, considering their new political structure in the early years of the present century, and their growth trend, they may surpass Iran in this area in the future (in the near future for Iraq and a little later for Afghanistan due to special circumstances). Let the numbers speak: Iraq’s health per capita in 2011 was $160 and in 2012 it was $226.4. This figure for Afghanistan in 2011 was $48.2 and in 2012 it was $51.2. But for the Islamic Republic of Iran, it has reached $325.7

Insurance and the insurance industry in Iran suffer greatly from various diseases. Diseases that are not only related to economic issues and recent sanctions. The first problem is the lack of insurance culture in the country, and this poverty of insurance culture in Iran has persisted despite years of advertising and the use of all government and non-government facilities that still remain.

Another issue for insurance in Iran is the non-insurability of government managers; a government manager in Iran comes with a senior manager and leaves with him. The number of managers in banks and economic enterprises in Iran that have been replaced in the past decade is evidence of this. In fact, insurance is seen as a citizen’s right and ensuring it is not a fundamental human and social issue, but a political one. Senior managers in this field also strongly advocate for this issue, fearing that it may become a problem for them; a problem that is not seen in neighboring countries such as Turkey, the Emirates, and even Iraq and Afghanistan, where senior managers are subject to general legal decisions. In fact, the two constructs of person-centered and law-centered are in opposition to each other in this field and experience has shown which one is superior.

Another issue is the weakness of insurance laws in the country, which results in non-competitive domestic and foreign insurances. In this lack of competition, the quality of services is not prioritized in the development of Iran’s economy.

Furthermore, our insurance system has its own problem. A system that is not reflected in modern insurance structures.

Insurance in Iran is a public, citizenship, and human right. Insurance is an industry, one that is closely tied to the issue of the health of the people. In the modern world, healthcare requires financial guarantees, and insurance is a crucial component of this. With the current dominance of capitalist ideology, the concept of health as a human right is directly related to insurance. Unfortunately, like other vital industries in Iran, insurance is also plagued by mismanagement and incompetence of those in charge. It is a struggling industry, at risk of bankruptcy, and any such event would result in the violation of the human rights of Iranian citizens. Like any other vital issue, insurance is also connected to the economic and political situation in Iran, and certain policies can lead to the destruction of this industry, which in turn would harm a significant portion of the population who rely on it. Currently, whether insurance exists or not does not make a difference in the amount of financial burden on different segments of Iranian society.

1- Definition of the Insurance Market Experts website from insurance.

2- Maleki, Rouhollah, Social Security as a Human Right, Fundamental Rights Journal, Winter 1384, Issue 5, page 143.

3- Shakardost, Abdul Rauf, Investigation of the Insurance Industry in Afghanistan, Voice of Afghanistan (Ava), 9 November 2008.

4- Health and treatment system in Iran and the world, VISTA website.

5- Meiri Nezhad, Hadi, in which countries do they spend more for health, Khabar Online, August 14, 2013.

6- Same.