The Turkish Competition Authority (the “Authority”) is conducting a comprehensive investigation covering a significant number of insurance companies, private healthcare providers, and technical service providers operating in the health insurance market. Having regard to the scale of the investigation and the nature of the alleged infringements, it is considered that the matter may produce important consequences not only for the health insurance market but also for other segments of the insurance sector.
This note aims to provide a general assessment of the scope of the investigation being conducted by the Authority, the conduct under examination, and the potential outcomes thereof.
1. Scope of the Investigation
The Authority has previously examined the insurance sector primarily in the context of merger and acquisition transactions. In this regard, the Competition Board (the “Board”) has previously considered the health insurance market to constitute a two-sided market.
In addition, in the course of a preliminary investigation conducted against two leading insurance companies in the sector, initiated upon the claim of a private hospital, the Board examined the bundled offering of complementary health insurance (“CHI”) and private health insurance (“PHI”) products, as well as certain contractual practices, yet ultimately resolved that there were no grounds for opening an investigation against either company. Nonetheless, that process demonstrated that the Authority closely monitors the relationships between health insurance companies and healthcare providers.
The current investigation was opened following a preliminary investigation initiated on the basis of notifications and complaints received by the Authority. By its decision dated March 16, 2026 and numbered 26-10/298-M, the Board resolved to open an investigation against a total of 19 undertakings operating in the Turkish health insurance market, with a view to determining whether Law No. 4054 on the Protection of Competition (“Law No. 4054”) has been infringed.
The investigation covers a total of 19 undertakings across three categories, reflecting the integrated structure of the health insurance market:
- Insurance companies
- Private healthcare providers
- Technical and operational support providers
The fact that the investigation includes insurance companies, healthcare providers, and technical support providers alike indicates that the Board is assessing the market as an integrated ecosystem.
2. Alleged Infringements
The principal allegations that are attributed in the context of the investigation are as follows:
- Pric fixing, increasing, or maintenance of premium amounts by competing insurance companies;
- The allocation of customers, territories, or products;
- The exchange of competitively sensitive information among competitors, including pricing, cost, and risk data;
- The conclusion of agreements between insurance companies and healthcare providers capable of making it more difficult for, or foreclosing, competitors’ access to the market.
Therefore, the investigation covers not only the relationships between competitors but also the commercial relationships between insurance companies and healthcare providers.
Indeed, the first three allegations, in the established practice of the Board, are regarded as among the most serious competition law infringements that may be characterized as cartel or cartel-like horizontal cooperation allegations within the scope of Article 4 of Law No. 4054. In this context, correspondence, meeting records, electronic communications, or other communications assessed by the Board as having an anti-competitive object may constitute significant evidence of an infringement.
The allegations concerning exclusionary agreements, on the other hand, may be assessed separately from the perspective of vertical relationships and conditions of market access.
While the investigation is focused on the health insurance market, it is possible that, should the Authority identify competition law risks in other segments of the insurance sector in the course of its examination, new inquiries may be initiated in those markets as well.
3. Key Considerations for Insurance Undertakings
The current investigation presents a significant opportunity for undertakings operating in the insurance sector to reassess their competition law compliance processes. In this regard, it may be crucial to review, in particular, the following matters:
- The assessment from a competition law perspective of sector meetings, trade association activities, and committee work conducted with competitors;
- The review of internal controls relating to the sharing of competitively sensitive information such as premiums, costs, risk acceptance and loss ratios, and pricing policies;
- The assessment of levels of awareness in relation to communications conducted via WhatsApp, Teams, email, and other communication channels;
- The examination of agreements concluded with healthcare providers, technical service providers, or other business partners for exclusivity, foreclosure, or market access-restricting provisions; and
- The updating of competition law training programs and reviewing preparations for dawn raid investigations.
4. Potential Sanctions
Should the investigation conclude with a finding of infringement, the following sanctions may be imposed:
- Administrative monetary fines: Where an infringement is found, the Board may impose an administrative fine of up to 10% of the undertaking’s annual gross revenue at the end of the preceding financial year. Additionally, it is possible for individual fines to be imposed on managers and employees found to have played a decisive role in the infringement.
- Behavioral or structural remedies: The Board may order the amendment of specific contractual provisions, the cessation of commercial practices, or the adoption of other measures for the purpose of remedying the infringement.
- Periodic penalty payments: Daily administrative fines may be imposed in the event of non-compliance with Board decisions or failure to fulfil obligations imposed thereunder.
Conclusion
The investigation decision may be considered one of the most significant competition law developments relating to the health insurance market, both in terms of the number of undertakings subject to it and the nature of the conduct under examination.
In particular, given that allegations of price-fixing, market allocation, and the exchange of competitively sensitive information are under scrutiny, the outcome of the investigation may be instructive not only for the health insurance market but for other segments of the insurance sector as well.
Accordingly, it is of material importance that undertakings operating in the insurance sector review their existing competition law compliance programs, assess areas of risk, and, where considered necessary, take preventive measures.
