Abusive Readjustments of Collective Private Health Insurance Contracts Based on Operating Costs: Violation of Constitutional and Consumeristas Rules in Force.

• Autor(a) principal: Silva, Joseane Suzart Lopes da
• Data de Publicação: 2015
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Revista de Direito, Globalização e Responsabilidade nas Relações de Consumo
• Texto Completo: http://www.indexlaw.org/index.php/revistadgrc/article/view/87
• topic: Keywords: collective health plans, Operating adjustments, Constitutional standards, CDC; Planos de saúde coletivos, Reajustes operacionais, Constituição federal, CDC

This article deals with the constant abusive readjustments of collective private health insurance contracts based on operating costs, resulting in a violation of constitutional and consumeristas rules in force. The problem is the harm caused by such increases for many users, have been identified by the high number of complaints in public agencies and individual and collective lawsuits. The topic selection is justified by mainstay in two basic arguments, the first concerning the high number of collective health plans today, behold, operators no longer aim to market the individual / family contracts; and the second referring to the fact that the National Health Agency (ANS) is limited to fixing the adjustment percentage regard to the operational costs only for the individual contracts. The objective is to initially conceptualize and characterize the collective health insurance contracts, differentiating them from the individual and / or family, as well as presenting the species - which will be implemented within the first subject. Then intended to clarify what constitute the adjustments backed in operating costs, distinguishing them from other forms of increase. It will be transposed, after the explanation for the treatment of disrespect to the constitutional rules and consumer rights, the social function of the contract and the objective good faith of consumers. The hypothetical deductive methods, hermeneutic and argumentative were used, the critical methodological aspect, and exploratory research literature nature. It was concluded towards the prevention and combating of the star-crossed adjustments must be express conferral of ANS by specific resolution editing on the theme, as the social function of the contract and the objective good faith users may not remain transgressed, engendering often the termination of the contract by the impossibility of continued payment.