The four big Dutch health insurance companies are taking action against a private company which operates a string of family doctor practices and have formally accused it of failing to provide proper care.

Zilveren Kruis, CZ, VGZ and Menzis say the company Co-Med, which avoided bankruptcy for non-payment of bills earlier this month, is not meeting agreements on patient care, the Volkskrant reported on Wednesday. “We have reached the limit,” a spokesman for CZ told the paper.

The accusation is the first step in a process of breaking open their contracts with the doctors’ firm, which could eventually lead to thousands of patients being without insurance coverage for visits to their GP.

On Tuesday the insurance companies told Co-Med to provide it with information about rosters in the coming four weeks, but that did not appease their worries, hence the official complaint, the Volkskrant said.

Co-Med has been trying to build up a position in the Dutch healthcare market. It was launched in 2019 by three Limburg businessmen, who said at the time the aim was to relieve doctors of their support tasks, such as roster planning and bookkeeping.

The company now owns 13 family doctor clinics, many of which were bought from doctors who were retiring and had not been able to find someone to take over their practices. The company works largely with freelance doctors who are responsible for some 50,000 patients in Breda, Zwolle, Amsterdam, Eindhoven and Enschede.

However, its operations have been hit by a string of complaints about accessibility, poor care and the use of unqualified staff. Health ministry inspectors have also ordered the company to “improve the availability and accessibility of care”, saying Co-Med has shown “serious shortcomings”.