J.A.Y. had private health insurance with PVZP. He had a sudden mental breakdown, and as his condition was considered harmful for others he was hospitalized for 40 days in Bohnice Psychiatric Hospital against his will. The insurance company rejected the claim of 64 000 czk for the hospitalization saying that mental health management is excluded from insurance coverage.
The case went to court, 6 years later Constitutional court of the Czech Republic ruled in favor of the hospital and PVZP.
Source: I.ÚS 3536/14
K.S. was officially employed, thus she was entitled to a public health insurance and had one with VZP. Unfortunately, her baby girl was born several months early and stayed in Motol hospital NICU from 6/8/2009 till 2/10/2009. K.S. didn’t have permanent residence permit yet (which foreigners from non-EU countries obtain after 5 years of residing in Czech Republic) so her daughter wasn’t automatically eligible for public health insurance with VZP and all private health insurance companies refused to insure the preemie.
K.S. applied for all possible residence permits for her kid on 26/08/2009 – long-term residence, permanent residence for reasons worth special consideration and international protection. Her daughter has been granted asylum and with it public health insurance, but the Motol hospital still sent her the bill of 223 161 czk for neonatal care for the period 6/8/2009 – 25/8/2009 as the public health insurance company VZP refused to pay the costs for the timeframe before K.S. applied for international protection.
It took 7 long years till High Court of Justice finally declared, that as long as K.S. applied for permanent residence permit for her daughter, although she was declined it in 15/4/2011 under reasons of being granted asylum, her daughter should have been publicly insured from the moment of birth till 15/4/2011 and the bill goes to VZP.
Source: 33 Cdo 2039/2015
A coffee break gone wrong resulted in half a cup of freshly brewed coffee landing on my newborn’s leg. Me and my husband have immediately put the baby under cold running water and called 155 to ask for further instructions – 4 minutes later an ambulance was standing in front of the house. We called the insurance company (we have signed the most expensive contract on the market with PVZP) the same day and the assistance told us we are good.. only to call us back 2 days later saying that they had changed their minds and we will be denied any compensation because the insured person (4 months old baby) hasn’t done everything possible to prevent the insured event.
The Vinohrady hospital took our side and wrote a letter where it disagreed with the insurance company, appealing to common sense and asking them to reconsider the case. We wrote another official request, mentioning that not only there is no such paragraph in the contract saying that the compensation can be denied because it was the insurer’s fault, but there simply can’t be one as The Immigration Law §180j article 7 clearly states that proper medical health insurance for foreigners must have full unconditional coverage for trauma.
Don’t know what worked but 4 days later we got another call from the assistance saying that my baby girl’s treatment will be fully payed for, no explanations or excuses for stealing one week of our lives given.