Is it Legal? Requesting Donations from Patients Covered by the Social Security Institution (SGK), Methods of Recovery, and the Litigation Process

One practice that has frequently come to the fore in private hospitals in recent years is the request for money from patients or their relatives under names such as "donation," "support fee," "foundation contribution," "voluntary payment," and "assistance." These payments, often requested before surgery, during intensive care, or at the discharge stage, are frequently presented as if they were mandatory.

Is it legal for private hospitals to collect money under the guise of donations? Can donations be requested from patients covered by the Social Security Institution (SGK)? Can this payment be reclaimed? Does it constitute a crime under criminal law?

This comprehensive guide details the legal nature of fees collected under the name of "donations," patient rights, the refund process, and legal avenues.

1. Legal Definition of the Concept of "Donation"

A donation (gift), according to the Turkish Code of Obligations, is the act of one person giving something from their assets to another without compensation. The fundamental elements of a donation gratuitousness and voluntariness.

Well:

It cannot be mandatory
It cannot be conditional
It cannot be in exchange for services
Cannot be obtained under pressure

If a payment is conditional on the provision of healthcare services, it is no longer a donation but a fee.

2. How is the donation process implemented in private hospitals?

Examples encountered in practice:

"You need to donate to the foundation for the surgery."
"A support fee is charged during the intensive care process."
"The Social Security Institution (SGK) pays, but you are expected to make a donation."
"This isn't mandatory, but it needs to be done."

In most cases, the patient is given a receipt; however, payment is effectively mandatory.

Such practices create serious legal problems.

3. Can donations be accepted from patients covered by the Social Security Institution (SGK)?

Private hospitals contracted with the Social Security Institution (SGK) are subject to the provisions of Law No. 5510 and the Health Application Communiqué (SUT).

These hospitals:

It cannot exceed the wage limits set by the Social Security Institution (SGK).
It cannot exceed the additional fee rate.
They cannot charge extra for prohibited transactions.

If money collected under the guise of a "donation" is actually payment for healthcare services, this constitutes a circumvention of regulations.

In this case, the payment is illegal.

4. Donation or Hidden Payment?

In law, content matters more than form. Even if the payment is received with a donation receipt:

If it's related to the service
If it is a condition for the provision of the service
If pressure has been applied to the patient

This isn't a donation; it's considered a hidden fee.

This constitutes an unlawful collection of debt.

5. Requesting Donations in Emergency Situations

Private hospitals for emergencies:

They have to admit the patient.
This cannot delay the intervention.
No fee can be charged.

Telling someone they "need to donate" before an emergency operation is clearly against the law.

This situation may result in administrative penalties and criminal liability.

6. Request for Donations During the Intensive Care Process

One of the most sensitive areas is intensive care.

From the relatives of a patient whose life is at risk:

"If you don't donate, the intensive care process will be difficult."
"You need to pay the support fee."

Such demands are unlawful.

Such practices constitute a violation of patient rights.

7. Evaluation from the Perspective of Consumer Law

According to Law No. 6502 on Consumer Protection:

Unfair terms are invalid.
Transparency is essential.
Unilateral practices detrimental to consumers are prohibited.

Collecting mandatory payments under the guise of donations constitutes an unfair commercial practice.

8. Evaluation from the Perspective of Criminal Law

Depending on the situation, the following crimes may be involved:

Abuse of power
Qualified fraud
Unjust enrichment

If a donation is obtained by force or is conditional on a service, it may result in criminal liability.

9. Can a donation be reclaimed once it has been made?

Yes.

If you donate:

If not a volunteer
If it depends on the service
If given under duress

It is legally revocable.

Legal basis:

Unjust enrichment
Unfair conditions
Impaired willpower
Consumer law

10. How Does the Return Process Work?

1️⃣ Written Application

A return request is sent to the hospital.

2️⃣ Complaint to the Social Security Institution (SGK)

An application is made to SGK (Social Security Institution).

3️⃣ Provincial Health Directorate

An administrative investigation will be initiated.

4️⃣ Consumer Arbitration Board

It is mandatory for disputes below a certain monetary limit.

5️⃣ Consumer Court

A lawsuit is filed.

11. Documents Required for Proof

Donation receipt
Bank statement
Hospital correspondence
Witness statements
Patient file

Any document proving that the payment is tied to a service is important.

12. Statute of Limitations

Generally:

Two years for unjust enrichment (from the date of learning)
5 years in consumer transactions
The general statute of limitations is 10 years

13. Donations to Foundation Hospitals

Similar practices can also be observed in private university hospitals.

However:

The nature of public service is taken into consideration.
Social Security Institution regulations are still binding.
Donations cannot be made mandatory.

14. Is Compensation for Non-Pecuniary Damages Possible?

If:

If the patient's relatives have been pressured
If discharge has been delayed
If psychological harm has occurred

Compensation for emotional distress may be claimed.

15. Judicial Trends

Courts generally:

Focus on content, not form
Considering mandatory donations as fees
He/she is making a comment in favor of the patient

16. Most Common Scenarios

Donation requirement before surgery
Support fee in intensive care
Foundation contribution from a patient covered by SGK (Social Security Institution)
Donation request at the discharge stage

Most of these situations are illegal.

17. The Importance of Legal Support

Health law and social security legislation are technical fields. Professional support:

It speeds up the process
It prevents loss of rights
It facilitates evidence gathering

18. Conclusion: Can Money Received Under the Guise of Donations Be Reclaimed?