Clipping of news on Brazilian Culture, Law and Citizenship
02.03.2016
This article was translated by an automatic translation system, and was therefore not reviewed by people.
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Posted by Reinaldo Laviola Verner - 22 minutes ago
The Hospital Group Rio de Janeiro LTDA. - So Health was ordered to pay $ 10,000 in punitive damages to a client who had emergency medical treatment denied by the institution. Pay also material damage related to the procedure. The decision is the 12th Civil Chamber of the Court of Minas Gerais (Minas Gerais Appeal Court), which partly reformed judgment rendered by the District of Cataquases (da Mata region).
The woman narrated the case who lived in Rio de Janeiro and was taken by his son to Cataguases, in December 2013, to spend the year-end festivities with family. On January 14, 2014, she suffered a fractured left femur leg in an accident at home, requiring emergency surgery.
According to the client, the application for authorization for the procedure was denied. The hospital group claimed that the application should be made to Abramge (managed care Brazilian Association), which, in turn, claimed that the patient herself should bear the costs of the procedure off plan's area of agreement between the parties . The institution added that the hospital had no special agreement in Cataguases.
In court, the patient asked for compensation for the damage incurred so far and by expenses related to the treatment of injury, such as medical consultations and physiotherapy. Also requested compensation for moral damages and at the outset that the health plan was required to comply with contractual obligations. The request for preliminary injunction was denied.
In his defense, the company said that the contract between the parties did not cover the questioned area, with a view to accredited plan network. He stated that the recipient is aware of this limitation in the procurement act and the User's Manual, which made incabível reimbursement of expenses.
Fragile moment
In First Instance, the group was sentenced to pay material damages related to procedures on an emergency basis (medical fees of surgery and hospital expenses), amounting to approximately R $ 6000. As the request for punitive damages was denied, the patient appealed.
In analyzing the case, the judge rapporteur, Marco Antonio Melo, noted that in the first instance it was decided that the negative coverage was improper. As this was not questioned by the company, it was up only evaluate an application for compensation for moral damages.
In assessing the judge, "the denial of medical treatment entails undeniable extraordinary shock to the individual at a time of great weakness, reaching therefore the dignity of the human person can not be considered mere ordinary unpleasantness."
The rapporteur partially amended the decision to condemn the group to also pay compensation for moral damages, setting the value at R$ 10,000. The judges Saldanha da Fonseca and Juliana Campos Horta voted according to the rapporteur.
Source: JusBrasil
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This article was translated by an automatic translation system, and was therefore not reviewed by people.