Brazilian court stops the cancellation of health insurance coverage for a child with a rare syndrome
Key Points
- 1. The Akre State Justice Palace rejected the health insurance company's appeal, preserving the child's treatment coverage.
- 2. The child is diagnosed with autism spectrum disorder and the rare Wolf-Hirschhorn syndrome.
- 3. The court ruled that it was not proven that the customer was properly notified about the termination of the contract.
- 4. It was emphasized that discontinuing the treatment would violate the fundamental right to health and human dignity.
The Second Civil Chamber of the Akre State Justice Palace (TJAC) upheld the decision to maintain the health insurance coverage of a child diagnosed with autism spectrum disorder (ASD) and Wolf-Hirschhorn syndrome, a rare genetic disease. The court rejected the insurance company's appeal, ruling that the contract could not be unilaterally terminated.
The Chamber stated that the termination could not be considered valid on the grounds that it could not be proven that the legal entity establishing the contract had received an official notification regarding the termination of the plan. Furthermore, the judges emphasized that interrupting the treatment would jeopardize the continuity of the child's medical care. The decision noted that multidisciplinary and continuous medical monitoring, which is mandatory for the protection and development of the minor patient's health, was being received.
The court concluded that the sudden suspension of the assistance would violate the principles of good faith, the social function of the contract, human dignity, and the right to access health care. It was also added to the decision that the mere sending of correspondence cannot be accepted as definitive proof that the other party was aware of the termination.
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Frequently Asked Questions
- 1. S: What is Wolf-Hirschhorn syndrome?
- C: In the news, Wolf-Hirschhorn syndrome is described as a rare genetic disease.
- 2. S: Why did the court cancel the health insurance company's decision?
- C: It was canceled because, despite the company unilaterally terminating the contract, it could not be proven that sufficient and official notification was made to the customer informing them of the termination.
- 3. S: What is the child's current medical need?
- C: To protect the child's health and development, they require uninterrupted and multidisciplinary medical monitoring and treatment.
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