Clipping of news on Brazilian Culture, Law and Citizenship
 


Consumer News

STJ prohibits health plans to limit the value of the insured's treatment

This article was translated by an automatic translation system, and was therefore not reviewed by people.


 


SAO PAULO - O STJ (Superior Court) decided unanimously that health plans may not limit the value of treatment and hospitalization of its members. This is because the limiting value is more harmful than the constraint length of stay, 302 Gist vetoed by the Court.

This summary states that the clause is unfair contractual health plan that limits the length of hospitalization of the insured.

Thus, according to the rapporteur, Aldir Passarinho Junior, Minister in the same way that has no logic to determine the contract term recovery of the patient, can not merely the cost of treatment and healthcare.

For him, the formula ceiling value adopted by the insurer is an attempt to circumvent the prohibition of a time limit imposed by the scoresheet.

Loss sense
The example of limiting the length of hospital stay, highlights Passarinho Junior, when the value of restricted funding, empties the purpose of the contract, which is to provide the means to cure, regardless of health status of the patient.

The minister believes that it is clear that limit the value of treatment is detrimental to the insured, because it reduces the effectiveness of treatment.

Damage to the consumer
He questions, for example, how would the situation of an insured person is hospitalized without knowing what you have, not knowing your kind of healing and after a few days in the hospital, is told that their credit ran out and had to leave the treatment .

And asks: how do you know in advance what the cost of treatment, which the table of each hospital with and how long your credit will last?

Due
For example, if tried, the family of Alberto de Souza Meirelles, São Paulo, appealed to the court against the decision of the ECJ (ECJ) in Sao Paulo, who did not recognize the abusiveness of the limited annual value imposed by the insurer Notre Dame.

Because the company refused to pay the cost over the value of 2895 Ufesps (Fiscal Unit of the State of SP), which was under contract, the family inherited a debt to the Samaritan Hospital (SP), where Mr. Meirelles was hospitalized for almost 30 days in 1996.


Source: InfoMoney

This article was translated by an automatic translation system, and was therefore not reviewed by people.

Important:
The JurisWay site does not interfere in the work provided by doctrine, why only reflect the opinions, ideas and concepts of their authors.


  Subjects list
 
  Copyright (c) 2006-2009. JurisWay - All rights reserved.