Plan remains obliged to fulfill obligations prior to the end of the contract

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The health plan continues to be obliged to cover surgeries that it had authorized before ending the collective agreement with the company. That's why the 5th Civil Chamber of the Court of Justice of Rio Grande do Sul reformed the sentence that approved a plan to cover a teacher's bariatric surgery. She had been prevented from having the surgery days before the end of her contract, already with the queue password. The plan must also pay compensation of R$10,000 for moral damages. The court, however, denied the teacher's request to restore her contract with the plan, because it was part of an extinct collective contract.

"There is no way to individually maintain a collective Iran Telegram Number Data contract that has already been terminated", voted the rapporteur, judge Jorge Luiz Lopes do Canto. In the first instance, the request was denied. According to judge Alexandre Schwartz Manica, from the 10th Civil Court of Porto Alegre, the jurisprudence of the Superior Court of Justice does not prohibit the unilateral termination of collective medical assistance contracts. He cites Special Appeal 1,119,370 as precedent. However, according to the rapporteur at TJ-RS, the company sent a notification to the health plan in October 2014, and the contract was terminated in December.



The surgery was authorized by the plan in November. Therefore, the surgery was approved before the end of the contract, and before the end of the plan's obligations. "The defendant's attitude in canceling the authorization password for the surgical procedure proved to be abusive, given the evident need to perform the surgery, given the condition of morbid obesity with comorbidities, highlighting the illegality of the conduct adopted, without complying with the guarantee given", wrote Lopes do Canto, in the ruling.