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Date: August 19, 2019
Posted by: CPDMA Team

Legal and company ombudsman work together to reduce lawsuits

Se antes o departamento jurídico e a ouvidoria tinham papéis estritamente definidos e pouco flexíveis dentro das empresas, hoje eles podem andar juntos. É o que mostra experimento feito pela empresa de saúde suplementar Amil, que aproximou os dois setores para evitar litígios.

O projeto surgiu depois que a operadora percebeu que muitas ações judiciais chegavam ao jurídico, mas podiam ser resolvidas na conciliação. Para reverter isso, a Amil decidiu investir em tecnologia e robôs (softwares) que rastreiam as principais demandas do consumidor. A diferença surge em quem gerencia isso: não mais o jurídico e sim a ouvidoria da empresa, que tem uma médica à frente.

"Como o foco passou a ser a conciliação com o consumidor, a ideia foi trazer a ouvidoria para captar os casos antes deles chegarem aos tribunais. Assim, a ouvidoria faz o contato com o cliente para saber a melhor forma de ajudá-lo", conta o diretor jurídico Eduardo Gil.

Somente depois que a ouvidoria fez o contato e chegou a um consenso o jurídico é acionado para proceder com o termo do que foi acertado.

O projeto começou em fevereiro deste ano. Segundo Gil, de lá para cá, o índice de sucesso de "temas elegíveis" para acordo é de 30 a 40%, que costumam ser resolvidos em menos de uma semana.

Resolução de demandas

A médica Andrea Fortes, ouvidora da empresa, explica que foi preciso qualificar o atendimento da equipe, que tem 20 pessoas, e adotar uma política de resolução de demandas no primeiro contato.

A ouvidoria da Amil conta com grupo de 20 pessoas e atende cerca de 6 mil contatos por mês, na maioria das vezes por telefone. De acordo com o departamento, a equipe fez cursos de conciliação e sempre mantém contato direto com o jurídico para entender a tecnicidade caso a caso.

"Agora os beneficiários do plano podem falar direto com uma médica, que vai entender exatamente o caso deles. Mesmo que sejam questões contratuais sensíveis. Isso ajuda a desafogar o departamento jurídico", afirma.

Fonte: Fernanda Valente via Conjur.

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