PS11828 - ICA: €5 million fine to Intesa SanPaolo RBM Salute and €1 million fine to Previmedical S.p.A. for unfair commercial practices
ISP RBM received over 10,000 complaints between January 2018 and October 2020. The evidences collected by the Authority show delays in the provision of services, withdrawals of authorisations already issued, difficulties in contacting customer service, arbitrary limitations in the settlement practice.
The Italian Competition Authority has imposed a fine of 5 million euros on Intesa Sanpaolo RBM Salute S.p.A., an insurance company specialising in health insurance, and fine of 1 million euros on Previmedical - Servizi per Sanità Integrativa S.p.A., a service provider entrusted with the management and settlement of accident claims.
The investigations were initiated after the report from “Altroconsumo”, which had received about 1,000 complaints between January 2018 and October 2020, as well as the result of the supervisory activity carried out by IVASS, which had, in turn, ascertained over 1,100 complaints in the same period. In addition, during the the proceedings, the ICA received more than 70 requests for intervention from consumers complaining about the same problems. As communicated by Intesa Sanpaolo RBM, between January 2018 and October 2020 the company received 10,102 complaints, the vast majority of which relate to the profiles under investigation according to the opening of proceedings communication. Many complaints come from members of the MètaSalute health fund, which alone gathers more than a third of the number of ISP RBM policyholders.
According to the Authority, the conduct of Intesa Sanpaolo RBM Salute S.p.A. and Previmedical constitutes unfair commercial practice in violation of Articles 20, paragraph 2, 24 and 25, paragraph 1, letter d) of the Consumer Code, because the companies have made the use of insurance services onerous and difficult for consumers.
In particular, from the evidences collected during the proceedings, it appears that the policyholders were confronted with requests rejected with pretextual reasons, with delays in the responses and in the management of direct services, withdrawals of authorisations already issued, arbitrary limitations introduced in the settlement practice, difficulties in contacting customer service, which proved to be ineffective. Intesa Sanpaolo RBM Salute S.p.A. and Previmedical were aware of these problems, given that, among other things, during the inspection the Authority found emails from which it emerges that some percentage data of delay communicated to the health funds (0.47%) were not true (in fact, the actual percentage was 15%).
In addition, the documentation acquired shows inconvenience for policyholders due to pretentious requests for integration of the reimbursement claims - despite all the documentation was already in the company’s possession - as well as the application of different rules for each compensation for the same service.
It was also showed that delaying procedures were adopted to authorise services that involved cycles of several sessions, like in the case of oncological therapies, so that consumers, even those who needed urgent treatment, because they were affected by serious diseases, were forced to send a specific request for each session of the cycle. With particular reference to the members of the MètaSalute health fund, it was found that the actual timings for issuing the voucher for the provision of services was much longer than those provided for in the contract.
In many cases, it also occurred that the voucher was withdrawn after its release. For example, between January 2018 and September 2020 Previmedical revoked 52,185 authorizations previously issued to MètaSalute policyholders, regardless of the motivation.
Rome, 30 July 2021