Unanimously, the Second Section of the Superior Court of Justice ruled that health operators cannot disconnect a person from a collective health plan or insurance or deny coverage when there is a serious illness to treat.
The ministers analyzed two appeals against decisions that benefited two users. In one of them, the patient is undergoing medical treatment for breast cancer, and had her treatment cancelled.
In another, a minor requests maintenance of corporate collective health insurance because he is undergoing medical treatment for a serious illness capable of losing his life.
The collegiate decided that the operator, even after regular exercise of the right to unilateral termination of the collective plan, “shall ensure the continuity of the assistance care prescribed to the hospitalized user or in full medical treatment that guarantees their survival or their physical safety, until the effective high, provided that the holder fully pays the due consideration”.
The rapporteur, Minister Luís Felipe Salomão, voted against the appeals, and said that the operator must ensure the continuity of care until medical discharge.
“The impossibility of contract termination during the user’s hospitalization or his submission to medical treatment that guarantees his survival or maintenance of his physical integrity also reaches the collective pacts”, he said.
Salomão was followed by ministers Antônio Carlos Ferreira, Nancy Andrighi, Isabel Gallotti, Villas Boas Cueva, Marco Bellizze, Paulo de Tarso, Moura Ribeiro, Marco Bruzzi and Raul Araújo.
Source: CNN Brasil
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