Clipping of news on Brazilian Culture, Law and Citizenship
07/28/2015
This article was translated by an automatic translation system, and was therefore not reviewed by people.
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Customer shall also receive compensation of R$ 10,000; still subject to appeal
Read more about this topic in SÃO PAULO - The 7th Chamber of Private Law of the São Paulo Court of Justice ruled that Unimed Paulistana should pay for an experimental drug to treat a customer breast cancer. The operator of health plans will also be required to indemnify the client for R$ 10,000 due to damage caused by the initial refusal to pay for the drug, labeled Placlitaxel.
According to the federal judge Mary Grün, rapporteur of the process, companies in the sector "can not refuse to cover drug to be used in chemotherapy prescribed by the specialist doctor, since the disease has treatment covered by the agreement signed between the parties "he wrote in the judgment of the decision on appeal.
In his defense, the company had claimed he needed not afford the medicine, because it is experimental and has not been approved by the National Health Surveillance Agency (Anvisa). Understanding the magistrate was another: "the list published periodically by the regulatory agency does not serve as a way to limit the obligations of health plans."
A federal judge found that the National Agency for Sumplementer Health (ANS) is not able to keep pace with the findings of medical sciences. "Once discovered new methods, more efficient and less harmful to patients, it is not necessary to wait for the ANS expressly mention the requirement for its coverage, to ensure it is offered to patients who have health insurance coverage."
The plaintiff in the lawsuit also demanded compensation for moral damage, since the carrier's refusal would "put at risk his life." A federal judge upheld the request, as "illicit breach of contractual obligations entered into by the defendant caused great psychological and emotional disorders to the consumer (...) further increasing the risk and the physical discomfort that their health condition already submitted."
The judges Romolo Russo Junior and Ramon Mateo Junior participated in the trial, which was unanimous.
In a statement, Unimed Paulistana said following guidelines of the ANS and ANVISA with regard to the supply of medicines to its users. He also said that as there is not a final court decision, will appeal this case. Resources, declaratory embargos, will first be filed in the proper São Paulo Court of Justice. Later, if maintained the decision, the possibility of a special appeal to the Superior Court of Justice (STJ).
Read more about this in http://oglobo.globo.com/economia/defesa-do-consumidor/operadora-de-planos-de-saude-obrigada-pagar-por-medicamento-experimental-contra-cancer-16978361#ixzz3hD67Cjv2
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Source: Reuters
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This article was translated by an automatic translation system, and was therefore not reviewed by people.