Análise jurisprudencial acerca da aplicação do Rol de Procedimentos da ANS nos contratos de planos de saúde

• Autor(a) principal: Ribeiro, Tiago Teixeira
• Data de Publicação: 2019
• Tipo de documento: Trabalho de conclusão de curso
• Idioma: por
• Título da fonte: Repositório Universitário da Ânima (RUNA)
• Texto Completo: https://repositorio.animaeducacao.com.br/handle/ANIMA/6788
• topic: Plano de saúde; Operadora; Beneficiário; Direito à saúde; Rol de Procedimentos e eventos da ANS

The relationship between health plan beneficiaries and operators has brought legal discussions about whether or not to authorize health procedures and events. On the one hand, there is the operator, which is reluctant to exclude coverage on the grounds that the contract provides for such exclusion, as well as that the list established by ANS does not include the procedure claimed by the beneficiary. On the other hand, there is the beneficiary, who invokes the exemplary character of the role and the right to health enshrined in the Federal Constitution. Thus, the judiciary has understandings sometimes favorable to the operator, sometimes favorable to the beneficiary. Thus, we seek to analyze the jurisprudential positions adopted, and understand the application of the list of procedures and health events of the ANS in health insurance contracts.