Refund Process in Case of Double Charging

How to get a refund for overpayments at private hospitals, for procedures covered by the Social Security Institution (SGK), and for package deals?

One of the most common disputes in healthcare services in recent years double charging. Especially in private hospitals, charging twice for the same service in procedures covered by the Social Security Institution (SGK) or in package price agreements constitutes a violation of both consumer law and social security legislation.

So what is double charging? Under what circumstances is it considered illegal? How can a patient get a refund for an overpaid amount? How does the refund process work? In this comprehensive guide, we detail the refund process and legal avenues in case of double charging.

1. What is Double Collection?

Double charging is when two separate fees are charged for the same healthcare service or medical procedure, either separately or in two different ways.

Examples:

Charging the patient an additional fee for a procedure covered by SGK (Social Security Institution)
The item included in the package delivery/surgery fee should be billed separately
Prescribing the same test twice
Cash collection after the credit card transaction is processed
Full payment is received from both the Social Security Institution (SGK) and the patient
Charging a "service fee" again upon discharge

Such practices can clearly constitute illegal debt collection.

2. Why is the legal basis for double collection invalid?

Private hospitals providing healthcare services:

Turkish Code of Obligations
Law No. 6502 on Consumer Protection
Patient Rights Regulation
Social security legislation

are subject to obligations within this scope.

Double charging typically involves the following legal violations:

unjust enrichment
Breach of contract
Defective service
Violation of SGK (Social Security Institution) regulations

3. Double Collection under the Social Security Institution (SGK)

Private hospitals contracted with the Social Security Institution are required to adhere to the established tariff

In the SGK system:

The hospital may charge an additional fee.
No additional "service fee" can be charged for transactions covered by SGK (Social Security Institution).
No fees can be charged for emergency medical services.

If a hospital receives payment from the Social Security Institution (SGK) and also charges the patient the full fee, this is clearly double charging.

In this situation:

Any overcharged amount will be refunded.
The Social Security Institution (SGK) can impose administrative sanctions on the hospital.
Contract termination may be considered.

4. Double Collection in Package Price Agreements

Especially:

Birth packages
Cesarean section packages
Surgery packages
IVF packages

Double payment is frequently observed within this scope.

Example:

Even though the package deal includes anesthesia, room, surgery, and examinations, it is unacceptable to subsequently request additional fees under the guise of "additional materials," "anesthesia surcharge," or "doctor's fee.".

Collecting payments for items not explicitly mentioned in the contract is unlawful.

5. Billing for the Same Transaction Twice

One of the clearest examples of double charging is writing the same prescription twice.

For example:

Writing the same MRI in two separate copies
Repeated billing for the same blood test
Showing the same consultation twice

This situation could constitute both a violation of consumer law and an irregularity against the Social Security Institution (SGK).

6. Right to Restitution within the Scope of Unjust Enrichment

According to the Turkish Code of Obligations, a person cannot unjustly enrich themselves from another person's assets without a valid reason.

In case of double payment:

The hospital received payment without justifiable reason.
The patient has become impoverished.

In this case, the overcharged amount must be refunded.

7. Refund Process in Case of Double Collection

1. Invoice Review

First, the patient:

They should request a detailed billing statement.
The Social Security Institution should check the service record.
They should review the package deal.

2. Written Objection

A written application must be submitted to the hospital.

In the appeal petition:

Which item is subject to double collection?
Supporting legislation
Return request

It should be clearly stated.

3. Complaint to the Social Security Institution (SGK)

For transactions covered by SGK (Social Security Institution):

Applications can be made to the SGK Provincial Directorate.

The Social Security Institution (SGK) can initiate an investigation.

4. Application to the Provincial Health Directorate

An audit may be requested.

5. Consumer Arbitration Board

Applications are free if the amount falls below a certain monetary threshold.

6th Consumer Court

For disputes exceeding the monetary limit, a lawsuit is filed.

8. Claim for Monetary Compensation

Double charging is not limited to refunds for overpayments.

The following items may also be requested:

Credit card interest
Bank commission
Enforcement costs
Damage resulting from additional payment

9. Is Compensation for Non-Pecuniary Damages Possible?

If:

If an unfair debt collection process has been initiated
If the patient has been subjected to payment pressure
If he/she was humiliated by the hospital

Compensation for emotional distress may be claimed.

10. Criminal Liability

Double charge in some cases:

Qualified fraud
Forgery of official documents
Causing financial loss to SGK (Social Security Institution)

It may constitute crimes.

A complaint can be filed with the prosecutor's office.

11. How is proof established?

Evidence:

Invoice
Payment receipt
Bank statement
Social Security Institution (SGK) service record
Package deal
Witness statement

The court may order an expert examination.

12. Statute of Limitations

Generally:

2 years for consumer transactions
Two years for tort
Probably 10 years

However, the statute of limitations for criminal penalties is different if fraud is involved.

13. Common Types of Double Collection

The cost of the examination covered by SGK (Social Security Institution)
Exceeding the additional fee limit
Rewriting of the pen included in the package
Two separate pens for the same process
Emergency response fee

14. The Court of Cassation Approach

In Supreme Court rulings:

Refund of overcharged amount
Joint responsibility of the hospital and the physician
Application of unjust enrichment provisions

It appears that a decision has been made.

15. Mediation Process

In consumer disputes, mediation is mandatory before filing a lawsuit.

In mediation:

If an agreement is reached, an enforceable document will be created.
If no agreement is reached, a lawsuit will be filed.

16. What Should Patients Do If They Are Charged Double?

Examine the invoice carefully
Check your SGK (Social Security Institution) registration
Submit a written objection
Apply to the arbitration panel
File a lawsuit if necessary

Keeping the documents safe is extremely important.

17. Conclusion: Double Charging is Illegal and Must Be Refunded

Charging double is clearly against the law. In particular:

In transactions covered by SGK (Social Security Institution)
In package price agreements
If the additional fee limit is exceeded
If the same operation is written twice

The patient can request a refund for the overpayment.

Moreover:

Monetary compensation
Moral compensation
Criminal investigation

It may come up on the agenda.

To avoid losing your rights, it is important to handle the process carefully and seek support from a lawyer specializing in health law when necessary.

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