I worked on a system where we could see these people's behavior. I recommended that we take the top X and refund their money. They had problems, and it was unethical for us to continue to bill them. Senior management said, "No." Which was appalling to me. It would cost us nothing, all virtual bits anyway. To see the greed of taking a sick persons money is kinda depressing.
The system I worked on did 40M in revenue. We are talking about 10 people spending 5k a year (ish). So 0.5% of revenue for product that never even got activated? Refunding is the only correct response.