Clipping of news on Brazilian Culture, Law and Citizenship
05/03/2012
This article was translated by an automatic translation system, and was therefore not reviewed by people.
SAO PAULO - A special needs portability allows consumers dependent on holders of health insurance, but who lost that status, hire a new plan, in the same or another carrier, without having to meet new waiting periods or temporary partial coverage.
This portability has been permitted since the day February 28, 2012, as scores Idec (Brazilian Institute for Consumer Protection), noting that the rule applies to both old and new contracts. The rule is justified by the fact that the requirements mentioned have already been fulfilled in full or partially, in terms of origin.
Consumer law
IDEC remembers that include spouses and children as dependents on health insurance is a consumer right. The inclusion of parents, in-laws and brothers, on the other hand, depends on whether permission established in the contract. In business plans, the inclusion of dependents will happen under the contract.
Requirements
In the special case of portability, Idec said that the deadline for exercising such service is 60 days after the end of the connecting factor. However, there are other requirements that the consumer must observe.
- Being close to defaulting operator of origin of the plan, submitting a copy of proof of payment of the last three slips due, or statement of the legal entity contracting proving the due performance of the beneficiary in the last three salaries when applicable, or any other legal document to prove payment on time;
- Plan Destination be compatible with the type of the plane source, eg, with or without obstetrics, with or without hospitalization, etc.;
- The price range of the plan target is at or below that fits your plan origin, considered the date of signing the application form;
- The destination does not plan to be in a situation with a record of "active suspension with marketing," or "canceled".
It is noteworthy that, unlike other cases where portability is not necessary that the first portability needs the customer is in the plane of origin for at least two or three years in case the recipient has complied with temporary partial coverage.
Nor is it necessary, from the second portability, the consumer has at least one year of stay in the plane of origin. IDEC also points out that consumer's right to know exactly the full amount of tuition for each of the users and, if there is a discharge of a member of the family plan, the tuition should be decreased.
End of the condition of dependent
"If consumers lose dependent status while serving shortfall in the plan or the source is subject to temporary partial coverage, it will also be entitled to portability, but should take only the time already served and fulfill their remaining periods," says Idec.
If the plan is resulting in less than 24 months and paying tort period of change in the plan, the consumer can meet the period of temporary partial coverage remaining to complete those 24 months in terms of destination or pay another offense to be negotiated with the operator.
If the consumer is for 24 months or more in terms of origin, may exercise the special portability without the fulfillment of temporary and partial coverage without payment of injury.
Source: The Day on Line
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This article was translated by an automatic translation system, and was therefore not reviewed by people.