O papel da Justiça nos planos e seguros de saúde no Brasil

Detalhes bibliográficos
Autor(a) principal: Alves, Danielle Conte
Data de Publicação: 2009
Outros Autores: Bahia, Ligia, Barroso, André Feijó
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.
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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.
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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)
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