Clipping of news on Brazilian Culture, Law and Citizenship
09/09/2016
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The 4th Civil Chamber of the TJ filed an appeal by an 80-year-old woman to award compensation for moral damages in the amount of R $ 7,000, to be paid by her health plan, which refused to cover surgery to curb ophthalmological risks. They, the blindness. She had glaucoma, cataracts and vitreous opacities, all of which were vision problems, which demanded surgery by the contractor. She demonstrated that the contract provided medical and hospital services in the area of ophthalmology.
Judge Joel Dias Figueira Júnior, rapporteur of the matter, pointed out that there was no express clause expressing exclusion, so that he classified the plan's refusal as "undue refusal." She was only able to undergo the surgery in question by judicial decision. He had not, however, obtained compensation for moral damages. "Moral damages are evident because, in addition to being the elderly patient and there is a risk of irreversible blindness, only the surgical procedure can be performed after the filing of the lawsuit and the granting of early protection," noted the rapporteur in his vote.
The decision of the chamber evidenced the absence of ground on the claim that the procedure was not emergency. "One can not fail to consider the evaluation of the professional who followed the clinical treatment of the patient and categorically stated the need for the surgical intervention, under penalty of definitive visual loss," concluded Judge Joel. The decision was unanimous (Appeal No. 0009553-66.2013.8.24.0036).
Photos: Press Release / Public Photos-Carts
Source: TJSC
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This article was translated by an automatic translation system, and was therefore not reviewed by people.