O papel da Justiça nos planos e seguros de saúde no Brasil
Autor(a) principal: | |
---|---|
Data de Publicação: | 2009 |
Outros Autores: | , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Cadernos de Saúde Pública |
Texto Completo: | https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/3927 |
Resumo: | Consumer complaints against private health insurance plans and companies in Brazil have become increasingly frequent in the country's "supplementary" (non-public) health care sector, with numerous cases reaching the courts. The problem raised the need for regulation of this private market, which began in 1998, through Law no. 9.656. One of the challenges faced by the National Agency for Supplementary Health Care (ANS) is resistance to the legislation by health insurance companies, besides the fact that there are still some contracts not covered by this law. The objective of the current study was to analyze health insurance policyholders' appeals against court rulings for or against injunctions concerning coverage, in cases heard by the courts in Rio de Janeiro and São Paulo. The main data investigated were: court issuing the ruling; defendant; basis for the case; ruling by the Circuit Court and Court of Appeals; and the legal arguments. Based on the findings, the Brazilian court system still plays an important role in hearing and ruling on complaints by health insurance policyholders. The ANS has an important role in filling some gaps that have still not been solved in regulating the health insurance industry. |
id |
FIOCRUZ-5_395ee4cdb8dd76bf14ed1032ffd6b81d |
---|---|
oai_identifier_str |
oai:ojs.teste-cadernos.ensp.fiocruz.br:article/3927 |
network_acronym_str |
FIOCRUZ-5 |
network_name_str |
Cadernos de Saúde Pública |
repository_id_str |
|
spelling |
O papel da Justiça nos planos e seguros de saúde no BrasilPlanos de Pré-Pagamento em SaúdeRegulamentação GovernamentalPoder JudiciárioPolíticas PúblicasConsumer complaints against private health insurance plans and companies in Brazil have become increasingly frequent in the country's "supplementary" (non-public) health care sector, with numerous cases reaching the courts. The problem raised the need for regulation of this private market, which began in 1998, through Law no. 9.656. One of the challenges faced by the National Agency for Supplementary Health Care (ANS) is resistance to the legislation by health insurance companies, besides the fact that there are still some contracts not covered by this law. The objective of the current study was to analyze health insurance policyholders' appeals against court rulings for or against injunctions concerning coverage, in cases heard by the courts in Rio de Janeiro and São Paulo. The main data investigated were: court issuing the ruling; defendant; basis for the case; ruling by the Circuit Court and Court of Appeals; and the legal arguments. Based on the findings, the Brazilian court system still plays an important role in hearing and ruling on complaints by health insurance policyholders. The ANS has an important role in filling some gaps that have still not been solved in regulating the health insurance industry.A grande quantidade de reclamações dos consumidores de planos e seguros privados de saúde se tornou freqüente no setor suplementar, com reflexos sobre o Poder Judiciário. Essa problemática fez surgir a necessidade de regulação desse mercado privado, que se iniciou em 1998, por meio da Lei nº. 9.656. Um dos desafios que a Agência Nacional de Saúde Suplementar (ANS) enfrenta é a resistência das operadoras perante a legislação, além do fato de ainda existirem contratos não regidos pela referida lei. O objetivo do estudo foi analisar recursos de decisões judiciais que concederam ou não o pedido liminar da antecipação da tutela solicitado pelo consumidor de plano de saúde, julgados nos Tribunais de Justiça do Rio de Janeiro e de São Paulo. Os principais dados pesquisados foram: Tribunal que proferiu a decisão; réu; tema debatido; posicionamento de 1ª e de 2ª Instâncias e fundamentação jurídica. Verifica-se que o Poder Judiciário continua sendo um importante espaço de reivindicação dos consumidores de planos de saúde. O papel da ANS é importante para preencher algumas lacunas que ainda não foram solucionadas pela regulação do setor.Reports in Public HealthCadernos de Saúde Pública2009-02-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlapplication/pdfhttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/3927Reports in Public Health; Vol. 25 No. 2 (2009): FebruaryCadernos de Saúde Pública; v. 25 n. 2 (2009): Fevereiro1678-44640102-311Xreponame:Cadernos de Saúde Públicainstname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZporhttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/3927/7973https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/3927/7974Alves, Danielle ConteBahia, LigiaBarroso, André Feijóinfo:eu-repo/semantics/openAccess2024-03-06T15:27:53Zoai:ojs.teste-cadernos.ensp.fiocruz.br:article/3927Revistahttps://cadernos.ensp.fiocruz.br/ojs/index.php/csphttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/oaicadernos@ensp.fiocruz.br||cadernos@ensp.fiocruz.br1678-44640102-311Xopendoar:2024-03-06T13:04:30.656499Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ)true |
dc.title.none.fl_str_mv |
O papel da Justiça nos planos e seguros de saúde no Brasil |
title |
O papel da Justiça nos planos e seguros de saúde no Brasil |
spellingShingle |
O papel da Justiça nos planos e seguros de saúde no Brasil Alves, Danielle Conte Planos de Pré-Pagamento em Saúde Regulamentação Governamental Poder Judiciário Políticas Públicas |
title_short |
O papel da Justiça nos planos e seguros de saúde no Brasil |
title_full |
O papel da Justiça nos planos e seguros de saúde no Brasil |
title_fullStr |
O papel da Justiça nos planos e seguros de saúde no Brasil |
title_full_unstemmed |
O papel da Justiça nos planos e seguros de saúde no Brasil |
title_sort |
O papel da Justiça nos planos e seguros de saúde no Brasil |
author |
Alves, Danielle Conte |
author_facet |
Alves, Danielle Conte Bahia, Ligia Barroso, André Feijó |
author_role |
author |
author2 |
Bahia, Ligia Barroso, André Feijó |
author2_role |
author author |
dc.contributor.author.fl_str_mv |
Alves, Danielle Conte Bahia, Ligia Barroso, André Feijó |
dc.subject.por.fl_str_mv |
Planos de Pré-Pagamento em Saúde Regulamentação Governamental Poder Judiciário Políticas Públicas |
topic |
Planos de Pré-Pagamento em Saúde Regulamentação Governamental Poder Judiciário Políticas Públicas |
description |
Consumer complaints against private health insurance plans and companies in Brazil have become increasingly frequent in the country's "supplementary" (non-public) health care sector, with numerous cases reaching the courts. The problem raised the need for regulation of this private market, which began in 1998, through Law no. 9.656. One of the challenges faced by the National Agency for Supplementary Health Care (ANS) is resistance to the legislation by health insurance companies, besides the fact that there are still some contracts not covered by this law. The objective of the current study was to analyze health insurance policyholders' appeals against court rulings for or against injunctions concerning coverage, in cases heard by the courts in Rio de Janeiro and São Paulo. The main data investigated were: court issuing the ruling; defendant; basis for the case; ruling by the Circuit Court and Court of Appeals; and the legal arguments. Based on the findings, the Brazilian court system still plays an important role in hearing and ruling on complaints by health insurance policyholders. The ANS has an important role in filling some gaps that have still not been solved in regulating the health insurance industry. |
publishDate |
2009 |
dc.date.none.fl_str_mv |
2009-02-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/3927 |
url |
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/3927 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/3927/7973 https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/3927/7974 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html application/pdf |
dc.publisher.none.fl_str_mv |
Reports in Public Health Cadernos de Saúde Pública |
publisher.none.fl_str_mv |
Reports in Public Health Cadernos de Saúde Pública |
dc.source.none.fl_str_mv |
Reports in Public Health; Vol. 25 No. 2 (2009): February Cadernos de Saúde Pública; v. 25 n. 2 (2009): Fevereiro 1678-4464 0102-311X reponame:Cadernos de Saúde Pública instname:Fundação Oswaldo Cruz (FIOCRUZ) instacron:FIOCRUZ |
instname_str |
Fundação Oswaldo Cruz (FIOCRUZ) |
instacron_str |
FIOCRUZ |
institution |
FIOCRUZ |
reponame_str |
Cadernos de Saúde Pública |
collection |
Cadernos de Saúde Pública |
repository.name.fl_str_mv |
Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ) |
repository.mail.fl_str_mv |
cadernos@ensp.fiocruz.br||cadernos@ensp.fiocruz.br |
_version_ |
1798943364854317056 |