Clipping of news on Brazilian Culture, Law and Citizenship
06/05/2016
This article was translated by an automatic translation system, and was therefore not reviewed by people.
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For Brazil Economic
TJ / SP understood that the consumer would not know what value would be reimbursed and ordered the company to pay
The 5th Business Law Chamber of TJ / SP condemned the SulAmérica Insurance company to reimburse, in a comprehensive manner, the family of the insured for the expenses incurred outside the accredited network, lack of clarity in the contract as the repayment terms. The rapporteur of the case, Judge James Siano, ordered the company to pay R$ 141,300.
The value considers the payment of R$ 150 thousand as medical fees with repayment of only R$ 8,968.16 by the insurer. Thus, the heirs of the insured shall be reimbursed at R$ 141,031.82.
The judge upheld the earlier decision, understanding that there was abuse of the clause limiting reimbursement to the US tax basis, being "impossible to grasp what they are and what are the criteria used to create and update service units".
In the report, the judge also pointed out that the payment of attorneys' hours by 10% is fair, since "the value of the conviction, R $ 141,031.82, does not seem too high to base the arbitration contrary to the terms of art . 20, § 3 of the CPC / 73 (Art. 85 § 2 of the new CPC). "
Contact the Economic Brazil, the company's press office said that "SulAmérica does not comment on judicial decisions."
Source: Economic Brazil
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This article was translated by an automatic translation system, and was therefore not reviewed by people.