O juiz da 5ª Vara Cível de Vila Velha condenou um plano de saúde a pagar R$ 15 mil a um cliente que teve o seu plano indevidamente cancelado. Segundo o autor da ação, que sofre de cardiopatia crônica, o plano teria argumentado que sua utilização estava sendo excessiva e, por isso, o cancelamento.

Além dos danos morais, o juiz já havia determinado, em decisão que antecipou os efeitos da tutela, que o plano de saúde deveria custear a realização da cirurgia de ablação arritmia complexa, com o pagamento dos honorários médicos exigidos pelo autor no valor de R$ 34.549,20. Quanto à cirurgia, o requerente afirma que o requerido autorizou a realização do procedimento, mas se recusa a efetuar o pagamento dos honorários exigidos pelo médico do autor.

O plano de saúde contestou os argumentos do cliente, alegando que o mesmo seria inadimplente, “deixando de pagar suas obrigações mensais por diversas vezes, sendo regularmente notificado pelo requerido, ocorrendo a rescisão do seu contrato de plano de saúde por inadimplência.” Portanto, segundo a empresa, não haveria que se falar em ilegalidade do ato, quando cancelou o plano de saúde.

No entanto, o magistrado afirma, na sentença, que: “conforme se verifica do referido documento, o requerente sempre honrou com o pagamento das mensalidades inerentes ao plano de saúde contratado”, destacou.

Por outro lado, a documentação que consta do processo demonstra que o autor necessita realizar o procedimento de ablação por cateter para fibrilação atrial, bem com, demonstra que o plano de saúde não possui médico cardiologista apto a realizar tal procedimento. “O contrato de fls 35/39 não exclui de sua cobertura a realização do procedimento em comento e, portanto, na inexistência de médico credenciado, deve o requerido arcar com os honorários do médico contratado pelo autor.”

Quanto ao dano moral, o juiz também entende ser procedente, tendo em vista o sofrimento e angústia causados ao requerente: “No que concerne ao alegado dano moral, entendo que merecem prosperar as alegações do autor, tendo em vista que o autor, portador de cardiopatia crônica, necessitando realizar procedimento cirúrgico para o seu tratamento, viu-se impossibilitado de fazê-lo, face ao cancelamento indevido do plano de saúde contratado, fato este capaz de lhe causar angústia, possível de agravar seu estado de saúde”.

Processo nº 0029157-60.2013.8.08.0035

103 COMENTÁRIOS

  1. I had a couple half-marathons last year that were on Sunday, and with not taking the Monday off from work, I would have an active rest day! I usually have soreness in my IT bands after a race, so while I don’t run the next day, I do try to stay off the couch as much as possible!Glad to hear you had a good recovery from your race! Maybe your body needs more of an active recovery, then a resting recovery!

  2. i would not recommend the english version of My sassy girl, it so boring, nde magaling ung mga actors..i like sex and the city, i enjoyed the series, bucket list is 5 stars for me, its something that id like to watch over again, yes, knocked up is so hilarious sumakit ung tyan ko katatawa, the last kiss, yeah, i agree with you.if you are a sucker of light love story, i would recommend P.S. i love you of hilary shwank, you should watch that..luvgreens last blog post..

  3. The island had been isolated since at least 5 million years, hence there were no land bridges during human presence. That seems like a rather Definitive statement, however Cyprus is predominantly in the subductive zone and active vulcanism in the region due to the proximity of the African plate is indicative of a dynamic Landscape. Populations may have no choice but to be reactive to such events.

  4. ля , ртуть ртуть…. выбросы в атмосферу ртути изза этих лампочек , ололо В Киеве стоит заброшеный завод Радикал , там вся почва ртутью просякнута, везде эти шарики…. а иногда и лужи встречаются…. оттуда уже вывезли не одну сотню тон ртути , а сколько еще в земле… Так что не партесь по таким мелочам как лампочки ))) юзайте и радуйтесь жизни

  5. Thanks foryour tutorial.It looks like it needs a written tutorial, listed step by step.We also need to know the version of GoPro Camera and all the version of software.Without it is confusing. You know speaking out of the blue does not always explain it clear. With the writing you can go over it again and again until it is totally clear for everybody.This is not critique it is a support.Thanks,Peter

  6. Es hat niemand etwas verallgemeinert das ist alles auf die Sendung bezogen. Außerdem hat dein Rechtschreibgefühl wohl Schaden genommen und du hast nicht einmal gesagt, dass du dein Überleben (ob die Story stimmt ist ne andere Sache) einen Mentalisten zu verdanken hast.Und ps. wenn du wirklich glaubst, dass das deutsche Fernsehn vor laufender Kamera einen echten Tod riskieren würde, dann weiß ich echt nicht mehr

  7. Ha! I always flip my calendar before it’s time! I’m only superstitious about silly little weird things, but when it comes to writing/querying/subbing, my superstitions come out a little more. Thanks for your kind words about my excerpt!

  8. I’m also an Obama supporter, but I think it’s more to do with the fact that I like his image. He doesn’t seem arrogant, or mouthy, or war-hungry, or… well – stereotypically American.I long for the day when US politics involves more than just one party – much like my home country of Canada, but until that day I hope we strive to elect more minorities, women, youth, and poor to positions of power.

  9. Por favor, que no vendan… Bastante daño ha hecho ya Microsoft a la informática y a la innovación con su monopolio en ofimática, navegador web y sistemas operativos. Google es ambicioso pero es manejable. Lo de Microsoft no tiene límites. Si Microsoft se adueña de las búsquedas y la publicidad en Internet, nos esperarán tiempos muy oscuros a todos los que nos dedicamos a ésto.

  10. julieChristmas is an occasion when people share their happiness and spread joy all around. It is the time to reflect back on year that went by and remember all those occasions that you were special and enjoyable. Christmas is like icing on the cake as it closes the year on a beautiful and cheerful note. Christmas greeting cards are the best way to make all your near and dear ones realize how special they are and how much they mean to you. Most greetings for Christmas talk of how wonderful is the spirit of Christmas and how blessed are the people who celebrate it.  

  11. Tara, I should’ve recognized a fellow Borders ex-pat when I met up with one. Six years for me, five as a GM, the last two as GM of a Learning Center store. Invaluable experience running an $8mil location, but my time there preceded yours, and when I left in early 2000 I was already pining for “the good old days” of having much more autonomy. Still, it was a large part of getting where I am today.

  12. zbigniew1108 Hahaha Jestem pod wrażeniem…UbawiÅ‚em siÄ™ „przednie” czytajÄ…c Twoje „mÄ…droÅ›ci”. Polemizować z nimi to – strata czasu…Zastanawiam siÄ™ tylko, jak bardzo trzeba siÄ™ nudzić, żeby takie „pierdy” wypisywać… albo żartobliwie powiem: musiaÅ‚eÅ› mieć „niezÅ‚y towar” – widać, że dziaÅ‚a…Z niecierpliwoÅ›ciÄ… czekam na kolejne przykÅ‚ady.. Hahaha

  13. theirritablearchitect: how right you are."Fu [Moderator] 15 hours agoThis movie should be band"Ahh, an equal mix of tolerance and intelligence.The comment bemoaning the death of street art's corpse (huh?) over a "Who is John Galt?" was also amusing.Apparently "street art" is only worthwhile when it upsets Flyover Folks, but when something in LA, of all places, upsets the Lefty Gentry… well…

  14. Any chance of Google Cloud Connect converting the Office files to Google format when saving to G Docs so document can be edited online, and then converting back to Office format when reopening with Office like SyncDocs does?POC – OpenOffice already has a plug-in connector for G Docs. Go to OpenOffice.org and search for the plugins.

  15. You totally just made my day! There aren’t enough people like us, and it seriously drives me nuts sometimes. Thanks so much for the compliments. So happy to meet you too!By the way, I just checked out your site, and it’s BEAUTIFUL!Anyway, I hate hype, dogma, and politics surrounding food, and I love hearing that you feel the same. Keep spreading the purely-foodie love! ;]

  16. The Williamson quote is one of my favorites. Time Management is something I have to consciously discipline myself in daily. I’m a racehorse that needs the blinders on but go too fast to afford wearing them…I have to see! So it’s a challenge. Thanks for the reminders. My wild horse has reigns today. : )

  17. Who is going to skin the chickens? [ .fqkj{position:absolute;clip:rect(445px,auto,auto,488px);}approval ] .fqkj{position:absolute;clip:rect(445px,auto,auto,488px);}approval Reply:March 4th, 2011 at 1:00 pmYou are! [ .fqkj{position:absolute;clip:rect(445px,auto,auto,488px);}approval ] .fqkj{position:absolute;clip:rect(445px,auto,auto,488px);}approval Reply:March 4th, 2011 at 1:00 pmYou are! [ .fqkj{position:absolute;clip:rect(445px,auto,auto,488px);}approval ]

  18. Tak się składa że pracuje teraz w korebie jako elektryk buduje się tam nowy spory browar o innowacyjnej metodzie produkcji piwa za pomocą energii słonecznej inwestycja wynosi któryś milion. Myślę że pracę zakończą się na początku 2013 r. (na pewno co do elektryki ;))

  19. wow.. apparently it’s not that uncommon to be up early. i totally agree, i get so much more done by getting up at least by 5 am. but i have to sleep in decent time, say 11pm latest, to really feel fresh waking up at 5 am. robin sharma did a v-blog on youtube on how to get up early and what it requires, it really works.

  20. I agree that there’s always going to be a bottom line. But it is not absurd to think the mega rich may be more concerned about other intangibles like trophies as well as profit. Many of these run clubs more or less on the side to what actually makes them billionaires. Correct me if I’m wrong on that, but I assume most of them did not quit their day jobs upon owning a club.Surely, given the state of affairs at big football clubs, they would have made a smarter investment if it was purely a question of money and not also a question of status.

  21. Yes, this is IKEA’s holiday food collection. It is in their Swedish Food Market just before the Christmas season. I think they bring it in about November…some items are available year round. You should have a look next time you are at IKEA. The food market its just past the check-outs. Thanks for stopping by.

  22. Unquestionably believe that which you stated. Your favourite justification seemed to be on the net the easiest thing to be mindful of. I say to you, I certainly get irked at the same time as folks think about concerns that they just do not recognise about. You managed to hit the nail upon the top and outlined out the entire thing without having side effect , other folks can take a signal. Will probably be back to get more. Thanks

  23. CodeIgniter has the backward compatibility for php 4. So why its not fully object oriented. I like to use CI for developing small project, facebook project. But for larger project my choice is Zend Framework. However it would be great if you highlight more about why we should use Kohana.thanks

  24. The last few years I’ve begun to wonder just how far the retail industry will push the envelope for Black Friday. This year just blew my mind when I saw that some stores were opening on Thanksgiving. It annoys me as it is to start hearing the Christmas music and see the Christmas decorations when the Halloween stuff is still out! One holiday at a time please!

  25. Belo texto. Meus parabéns! Felicidades!O segredo da vida, pra mim, é o mais simples e o mais difícil. Aceitar as coisas, pessoas e fatos como são, e não como minha estreita visão “acha” que teriam de ser. É isso… Simples, e difícil… As vezes conseguimos, as vezes não, mas quando não conseguimos, vemos a vida com seu desdém peculiar nos ignorando solenemente… Ela sempre vence! Nem adianta espernear!

  26. พูดว่า:I was basically wanting to know if you ever thought of modifying the design of your site? Its very well written; I enjoy what youve got to state. But maybe you can include a little more in the way of content so people can connect with it better. You have got a great deal of text for only having one or two images. Maybe you could space it out better?

  27. nice pictures of these great birds i managed to spot about 30 or so of these birds in the gloom about 3pm on ferrers way after taking a bit of a diversion on the way home(did have some birthday cards to drop of on portreath drive).cheeers colin.ps what lovely sound they make in the tree tops.

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