By Brazil Stock Guide – Complaints against some of Brazil’s largest private health insurers gathered pace in the second quarter of 2026, rising far faster than the growth of their member bases.
A Brazil Stock Guide analysis based on data from Brazil’s National Supplementary Health Agency, or ANS, shows that the medical-hospital complaints index for six major groups and operators rose 9.4% in the period. The aggregate index climbed from 56.46 in the first quarter to 61.75 in the second.
The move was not simply the result of insurers adding more customers. The operators analyzed ended the quarter with about 20.6 million beneficiaries, up just 0.9%. The number of complaints included in the index calculation, by contrast, rose 10.3%, to 38,151.
That is precisely what the IGR — the General Complaints Index — is designed to capture. The ANS calculates the measure by taking the quarterly number of NIP complaints, dividing it by three to reach a monthly average, and then relating that figure to the average number of beneficiaries, using 100,000 members as the benchmark. In practical terms, an index of 60 means roughly 60 monthly complaints for every 100,000 beneficiaries. The higher the number, the greater the incidence of complaints relative to the size of the insurer’s customer base.
The deterioration was visible across all six major groups and operators included in the BSG review.
SulAmérica ended the quarter with the highest consolidated index in the sample, at 77.67, up from 71.00 in the first three months of the year. Porto Seguro Saúde, meanwhile, posted the sharpest deterioration, with its index jumping 17.4% to 68.11.
At Bradesco Saúde, the consolidated index calculated by BSG rose from 56.82 to 62.14. The company’s two operating registrations analyzed in the review had appeared on the ANS list of insurers showing complaint reduction in the first quarter, but were no longer on any list in the second.
The worsening trend also appeared at Amil, whose consolidated index rose from 54.38 to 59.94, and at Unimed Seguros Saúde, where it increased from 52.08 to 58.00.
For Hapvida/NotreDame, the pattern stood out for another reason: the group’s consolidated index rose from 51.91 to 55.96 even as the combined beneficiary base of the operations considered shrank by 1.2%.
For groups with more than one relevant ANS registration, BSG consolidated complaints and beneficiary bases before applying the same formula used in the official IGR calculation. The ANS publishes the index by individual operating registration, meaning the group-level figures shown in the analysis are not official agency figures.
A naturally more sensitive quarter
There is, however, an important caveat to the data.
The second quarter tends to be a more sensitive period for the sector, as annual premium adjustments become more visible in bills and communications with policyholders. That can lead to an increase in complaints related to prices, billing and contract terms, alongside issues more directly tied to medical care.
The aggregate figures do not show how much of the deterioration came from premium adjustments and how much resulted from problems such as authorizations, coverage, provider networks or service quality.
Even so, one point is difficult to ignore: the incidence of complaints rose much faster than the number of customers.
That is why the IGR is more revealing than the raw complaint count alone. Even after stripping out the effect of portfolio size, the complaints index for the major operations analyzed rose nearly 10% in just three months.
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