IAAHS JoCo 2025 – Interviews Episode 1: How Dissatisfied Customers & Legal Action Reshape Health Insurance

The judicialization of private health insurance is a widespread phenomenon in Brazil and it generates not foreseen expenditures and distress to all parts involved in it. The literature studies how complaints management aspects can influence the customer satisfaction. Meanwhile, other authors discuss on how heuristics can affect the customer’s expectation related to the health insurance. In both cases, when the consumer feels, somehow, unsatisfied it can result in the health judicialization. In Brazil’s scenario, the regulatory autarchy and the national council of justice indicates, respectively, an exponential raise in the complaints and lawsuits of private health insurance in the last years. Given that, the present study investigated if health quality and customer satisfaction factors, measured by the autarchy’s monitory indicators, can influence the amount destinated to the health insurer judicial claims and costs reserves. To verify those relations, the research utilized a linear regression panel data model, using information from each of the health insurers from 2018 to 2022. The results showed that health quality has a positive and significant effect with moral damage dispute. On the other hand, customer satisfaction has a negative and significant effect with the judicial reserves. Therefore, it can be perceived that companies with lower customer satisfaction expends more with health judicialization, while excessively health resources usage increases moral dispute when the consumer has that level of usage ceased.