The court upheld the decision of the judge in first instance. As such, the appellate court ruled that the national judge is under an obligation to raise the question whether a contractual term is unfair even if the consumer did not raise that as an issue during proceedings. According to the judge, the consumer needs protection because of the superior position the seller has towards the contractual conditions.
Further the appellate court ruled that a hospital is a seller in the sense of the Directive 93/13, because it engages in the selling of drugs, other goods and for the provision of services.
Next, the court stated that a conventional penalty clause and a conventional interest clause in a hospitalization declaration fall under the scope of the unfair contractual terms provisions of the Directive 93/13. In the court's view, the requirement of reciprocity of a penalty clause does not require a payment of both the consumer and seller. The requirement of reciprocity has to be understood as requiring for both parties a penalty clause when they do not fulfil their obligations. For every penalty clause that is applicable towards the consumer, a penalty clause should also be applicable towards the seller, in case he does not fulfil its obligations from his part. It is not required that the penalty clauses are equally formulated nor that they should contain an equal amount of penalties in case of applicability of the clause.
Finally, the court also confirmed that the nullity of the conventional penalty clause and interest clause does not imply that it is not possible to get compensation for damages relying on general national law. Considering article 6 of the Directive 93/13 it is therefore possible that a party can continue to rely on general national law to obtain damages, even where a contractual clause to that end has been considered an unfair term in a consumer contract.