Clipping of news on Brazilian Culture, Law and Citizenship
07/24/2012
This article was translated by an automatic translation system, and was therefore not reviewed by people.
For Amil, data not take into account the number of beneficiaries.
Procon made 6120 visits to the consumer in the first half.
Amil Group, Green Line Health System and Unimed Paulistana occupy the top rankings of the top ten health insurance carriers that have generated more demands on the sector customer service of Procon-SP, from January 1 to July 17, 2012.
Company Claims
Amil Group 457
Green Line 294
Unimed Paulistana 166
Intermédica 125
SulAmérica 109
Italica Saúde 55
Universal 48
CentroTrasmontano de São Paulo 42
Golden Cross 42
Bradesco Saúde 35
Prevent Senior 31
The rankings, released on Monday (23), was based on complaints that required mediation of the entity to be resolved - that coupled with requests for guidance and clarification of doubts totaled 6,120 customer services made by the body, only the first half of year.
During this period, the segment occupied the ninth place among the greatest demand, second only to banks, financial, fixed and mobile telephony, telephone sets, computer products and furniture.
According to Procon-SP, consumers have difficulty resolving their problems through the channels of service firms.
"The consumer pays for many years your plan and when you need it faces obstacles imposed by firms to obstruct the service, hoping to win by fatigue," he said in a statement, the CEO of Procon-SP Foundation, Paulo Arthur Goes .
It said the main problems encountered by consumers have delay or failure to authorize and scoring procedures, such as appointments and tests; negative coverage or reimbursement; accredited network changes without notice, both in quantity and quality of service, in addition readjustments of age in violation of the status of the elderly.
Response of business
Wanted by the G1, the Amil Group - which includes Amil, Amico, Dix and Medial - said she respects the law and is the largest provider network in the country. "The lifting of the Procon is based on total claims, regardless of the number of beneficiaries," says the company.
Regarding the number of complaints, the GreenLine reports that "strong measures adopted to improve its service through the capillary network hospital for surgical procedures, as well as the hiring of new units of medical and laboratory throughout Greater São Paulo ".
SulAmérica said to have been informed that the numbers collected by Procon refer to all complaints, requests and clarifications directed by the insured to the foundation.
"This means that in 2012 the company received 16 requests for preliminary information by month, with a base of 2.4 million customers, and in 84.3% cases of complaints / requests / questions were answered satisfactorily . "
The Golden Cross says acts in accordance with rules laid down by the NSA and reports that in a recent consultation with the regulator, has been well evaluated in relation to length of service to beneficiaries, meeting the deadlines.
"The company invests heavily in training their staff and improving the quality of its customer service systems. (...) The Golden Cross also reports that provides a network to meet the contracts referenced in each region compatible with the number of active members in the portfolio. "
According to Unimed Paulistana, all claims have sent return to a claimant 100%, "however, the point of view of the client, the request is not always met."
"These are called negative because they are not administrative contemplated in the contract, such as: lack, some tests or procedures, for which reason, the beneficiary may mention that his request was not answered, but not on the breach of contract by Unimed Paulistana, "he says.
For Bradesco Saúde and its subsidiary Mediservice, 35 complaints represent a minimum percentage of only .001% of total customers - on the portfolio of 3.6 million customers spread across the country.
The company also said that "consolidated its leading position in product quality, service and support to their clients, all measured by the performance evaluation conducted by the National Health Agency (ANS) - the Performance Index of Health Supplemental (IDSS) - having obtained full marks for the second consecutive time (in the range between 0.80 and 1.00). "
The Intermédica says that 93.9% of complaints were resolved and most of them were made by an association, due to rising tuition, which the company claims to have been approved by the Court. According to the operator, claims "in question, still unresolved, are eight in four months, two months for a universe of more than 2 million members, or less than 0.000001% of complaints not yet resolved / clarified ".
The G1 came in contact with all of these companies and awaits the return.
Source: G1
Our news are taken in full of our partner sites. For this reason, we can not change the content of these up in case of typing errors.
This article was translated by an automatic translation system, and was therefore not reviewed by people.