Health at risk
In the judgment on Theme 1,082, the Superior Court of Justice established that the health plan operator, even after regularly exercising the right to unilateral termination of a collective plan, must ensure the continuity of previously prescribed medical treatment until effective discharge, as long as the plan holder pays the monthly fee due in full.
Judge orders plan to provide treatment to worker even after dismissal
Based on this understanding, judge Wander Lage Andrade Júnior, from the 2nd Civil Court, Family and Orphans and Successions of São Sebastião (DF), guaranteed to a woman diagnosed with ulcerative colitis the right to maintain the corporate health plan under which she was a beneficiary.
The plaintiff joined the plan in September 2020. However, with the loss of her job, the operator unilaterally canceled the contract, despite her being under treatment.
When analyzing the case, the judge pointed out that the interruption of services provided by the operator due to the termination of the author’s employment relationship could not prevent the continuity of treatment.
“Suspending treatment may result in a recurrence of the disease, triggering once again abdominal pain, bloody diarrhea, and anemia, compromising the patient’s quality of life and working capacity, and may lead, in some cases, to more serious complications with indications surgical procedures and, in extreme cases, even death”, wrote the judge.
Therefore, he ordered the operator to provide treatment to the author, under penalty of a daily fine of R$1,000, up to a limit of R$30,000.
The author of the action was represented by the lawyer Aline Vasconcelos.
Click here to read the decision
Process 0702087-40.2024.8.07.0012
Tags: Workers undergoing treatment maintain health insurance dismissal
