Post by messi23 on Mar 12, 2024 5:08:58 GMT -5
Undue refusal of medical coverage by a health plan causes moral damages. This was the understanding applied by the 3rd Panel of the Superior Court of Justice condemning a health plan that refused treatment for a newborn. The case took place in Rio Grande do Sul and involved a baby who, days after birth, was hospitalized for 60 days. When contacted to pay for the treatment, the company informed that there would only be coverage for the first 30 days of hospitalization. The action was filed on behalf of the mother and child. The sentence, confirmed in the appeal ruling, denied the right to compensation for moral damages on the understanding that, as there was a subsequent action in which the health plan was ordered to pay for the child's treatment.
The alleged moral damages resulting from this Germany Phone Number were not proven. denial of coverage. "Although the minor's mother claims that she owed a debt to the hospital, there is no mention of the negative registration with the credit protection bodies", said the ruling. Furthermore, she would not have demonstrated the constraints generated by the debt. At the STJ, the rapporteur, Minister Nancy Andrighi, applied a different understanding to the case. According to her, compensation for moral damages is justified due to the fragile situation in which the child's mother found herself, who, in addition to worrying about her daughter's health, was surprised by the news of the impossibility of coverage by the plan.
Nancy Andrighi also highlighted that the jurisprudence of the STJ recognizes that the undue refusal of medical coverage is a cause of moral damages, as it aggravates the context of psychological distress and anguish suffered by the insured person who, when signing a health plan contract, has the legitimate expectation that you will not need to worry about this type of expense. “The latent concern and distress with medical and hospital expenses, on the part of the first appellant, even after the medical treatment, certainly affected the care of the child, now the second appellant, and the right of both to be compensated for the damages must be recognized morals suffered at the opportunity”, said the minister.
The alleged moral damages resulting from this Germany Phone Number were not proven. denial of coverage. "Although the minor's mother claims that she owed a debt to the hospital, there is no mention of the negative registration with the credit protection bodies", said the ruling. Furthermore, she would not have demonstrated the constraints generated by the debt. At the STJ, the rapporteur, Minister Nancy Andrighi, applied a different understanding to the case. According to her, compensation for moral damages is justified due to the fragile situation in which the child's mother found herself, who, in addition to worrying about her daughter's health, was surprised by the news of the impossibility of coverage by the plan.
Nancy Andrighi also highlighted that the jurisprudence of the STJ recognizes that the undue refusal of medical coverage is a cause of moral damages, as it aggravates the context of psychological distress and anguish suffered by the insured person who, when signing a health plan contract, has the legitimate expectation that you will not need to worry about this type of expense. “The latent concern and distress with medical and hospital expenses, on the part of the first appellant, even after the medical treatment, certainly affected the care of the child, now the second appellant, and the right of both to be compensated for the damages must be recognized morals suffered at the opportunity”, said the minister.