Published on June 12, 2020 News

The assessment of the health condition concerning the occupational diseases of the insured person is free of charge

If an employee asks a hospital to issue an assessment whether he suffers an occupational disease the evaluation of his state of health is covered by the public health insurance – regardless whether the outcome is positive or negative.

The complainant asked Karvinská Mining Hospital a.s. (hereinafter “KHN, a. s.”) for the assessment whether he suffers from occupational diseases or not. KHN a.s. elaborated the medical report on the non-recognition of occupational diseases in the complainant’s case and asked him to pay CZK 2,000 for issuing the report. The complainant refused to pay the amount in question since he was convinced that this medical assessment shall be covered by the health insurance. Therefore, the KHN, a. s. refused to hand over the assessment concerned to the complainant.

Therefore, the complainant approached the Ministry of Health which granted KHN, a.s. the authorization to assess occupational diseases. As he was not successful, he decided to file a complaint to the Ombudsman. After the inquiry, the former Ombudswoman Anna Šabatová revealed that even though the Ministry had been informed about this situation over a long period of time it was reluctant to initiate any proceedings with KHN, a. s., for its unlawful practices.

In the meantime, the General Health Insurance Company of the Czech Republic issued an opinion that the assessments of the health condition of an insured person, in terms of occupational diseases, are fully covered by the public health insurance, both in case of positive and negative results. This was also later confirmed by the District Court in Karviná, during the Ombudswoman's inquiry. The Court decided that KHN, a. s. collected the fee illegally and was ordered to ensure the refund.

Following the ombudswoman ‘s report on the inquiry, the Ministry of Health initiated the proceedings with KHN, a. s., regarding withdrawal of the above-mentioned authorization which have not yet been completed.

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