A case study focuses on the issue of solving the complaint of a health insurant related to the quality of provided health care and function of an individually elaborated ortopedic-prosthetic appliance of the “Canadian type“. The procedure of the case refers to an uneasy task of the revisory medical officer during the approval process. The difficulties stem from the willingness to accommodate the health insurant even in the case of complex competitive relationships among specialized ortopedic-prosthetic departments in the situation when the health insurance company is not able to make a contract with external revisory medical officer specialized in the field of orthopedic-prosthetics in the region. The procedure of selection of the department for making a new special prosthesis and the issue of financial coverage are presented in the above mentioned context. It is a typical example of a health and social issue in the practice related to approval and revisory activities of revision medical officer.

        Key words: quality of provided health care – complaint of a health insurant – approval activities of revisory medical