THEAntitrust fined 5 million euros Intesa Sanpaolo RBM Health, an insurance company specializing in health insurance, and for one million euros Previmedical – Services for Integrative Health, service provider entrusted with the management and settlement of claims. However Intesa San Paolo reiterates that most of the disputes refer to the period between 208 and 2020, prior to the acquisition of the company by the banking group.
THE ANTITRUST DISPUTES
According to the Authority, the two companies have implemented an unfair commercial practice making "expensive and difficult for consumers to use insurance services”, reads the note from the Antitrust.
The preliminary investigation shows that “the policyholders had to face request rejection with specious reasons, delays in responses and in direct performance management, permit withdrawals already released, arbitrary limitations introduced in the settlement procedure, difficulty in contacting customer assistance, which proved to be ineffective".
Of these problems the companies were aware, underlines the Antitrust again, given that "during the inspection, the Authority found e-mails from employees which show that some delay percentage data communicated to the health funds (0,47%) did not correspond to the truth (in in reality, the effective percentage was equal to 15%)".
Furthermore, "the acquired documentation reveals inconvenience for the policyholders due to specious requests for integration of reimbursement requests - despite all the documentation already being held by the company - as well as the application of different rules for each compensation for the same performance".
It was also found “the adoption of delay procedures to authorize services involving cycles of several sessions, as in the case of oncological therapies, for which consumers, even those who needed urgent care, because affected by serious pathologies, they were forced to send a specific request for each session of the cycle. With particular reference to members of the MètaSalute health fund, it turned out that the actual times for issuing the voucher for the provision of services were much longer than those contractually envisaged".
In many cases, "it has also occurred that the voucher was withdrawn after its release - explains the Authority - For example, between January 2018 and September 2020 Previmedical revoked 52.185 authorizations previously issued to MètaSalute policyholders, regardless of the reason".
“The investigations were launched following the report of Altroconsumo, which had received around 1.000 complaints between January 2018 and October 2020 - continues the Authority - as well as the results of the supervisory activity carried out by theIvass, which had acknowledged over 1.100 complaints in the same period. Furthermore, during the proceeding, the Antitrust received more than 70 requests for intervention from consumers who complained of the same critical issues”.
According to what was communicated by Intesa Sanpaolo RBM itself, "between January 2018 and October 2020 the company received 10.102 complaints, the vast majority of which relate to the profiles highlighted in the communication initiating the procedure - continues the note - Many complaints come from members of the health fund MètaSalute, which alone collects over a third of the number of RBM ISP policyholders”.
THE OBSERVATIONS OF INTESA SANPAOLO
The Antitrust disputes "mainly refer to the period July 2018 - July 2020, prior to the acquisition of Rbm Salute by Intesa Sanpaolo Vita, which materialized on 11 May 2020 with the birth of Intesa Sanpaolo Rbm Salute, a company that joined part – from that date – of the Intesa Sanpaolo Group”.
This is the first clarification from the Intesa Sanpaolo spokesman after the fine by the Antitrust. “Since its acquisition – continues the spokesman – Intesa Sanpaolo Rbm Salute has developed new and concrete actions, aimed at aligning the quality of the service offered to its policyholders with the high standards that characterize the insurance division and the entire Intesa Sanpaolo Group, including further strengthening of customer care and after-sales services. Furthermore, to further enhance the relationship of trust with the network of affiliated healthcare facilities, the company has implemented a series of initiatives capable of speeding up payment processes".
These interventions “have contributed to ensure that the Ivass complaints index of Intesa Sanpaolo Rbm Salute went from 12,94 complaints every 10.000 contracts in December 2018 to 3,94 complaints every 10.000 contracts in June 2021. To evaluate the work carried out in a concrete and impartial way, in recent months Intesa Sanpaolo Rbm Salute has carried out, through the company specialized in market research Nielsen, a qualitative survey, to verify the level of satisfaction with the service and assistance offered to policyholders and health funds, in the post-acquisition period.
This research, which involved a heterogeneous sample of policyholders and 27 healthcare funds (about 80% of the Company's fund portfolio), was completed in February 2021 and showed that two-thirds of the funds interviewed believe that the acquisition of Rbm, by the Intesa Sanpaolo group, has generated value and is confident about a positive future development".
