A 6ª câmara de Direito Privado do TJ/SP manteve decisão que condenou uma operadora de plano de saúde deve fornecer medicamento importado para tratamento de câncer a paciente, conforme prescrição médica.
Contra sentença condenatória, a operadora interpôs apelação, alegando que a lei 9.656/98 permite que defina seu rol de cobertura, conforme suas possibilidades, e que o medicamento pleiteado está excluído até mesmo do plano-referência. Sustentou que o medicamento não foi nacionalizado e não possui registro na Anvisa, de forma que legal sua conduta em recusar o fornecimento do medicamento.
A princípio, o relator, desembargador Vito Guglielmi, observou que, como se trata de instituições que visam ao lucro e que o contrato é tipicamente de seguro, “não se veda o estabelecimento de cláusulas limitativas de responsabilidade“.
“O que não se deve permitir, o que é bem diferente, com base no Código do Consumidor, é apenas a presença de cláusulas dúbias, omissas ou abusivas.”
No contrato em questão, o magistrado verificou a expressa vedação ao fornecimento de medicamentos importados não nacionalizados que, no seu entendimento, é lícita. No entanto, lembrou que a jurisprudência da Corte vem se firmando em sentido oposto, tanto que há duas súmulas (102 e 95) que proíbem a negativa de cobertura de tratamento ou medicamento, quando há indicação médica.
“Logo, tendo em vista que há expressa indicação médica para a utilização do medicamento descrito na exordial, que compõe o tratamento prescrito à requerente, a fim de evitar prolongamento da lide com a interposição de novos recursos, e levando em conta o interesse das partes, curva-se este Relator ao entendimento majoritário para manter a procedência da ação.”
Fonte: migalhas.com.br
Cookie | Tipo | Duração | Descrição |
---|---|---|---|
cookielawinfo-checkbox-analytics | 0 | 11 months | This cookie is set by GDPR Cookie Consent plugin. The cookie is used to store the user consent for the cookies in the category "Analytics". |
cookielawinfo-checkbox-functional | 0 | 11 months | The cookie is set by GDPR cookie consent to record the user consent for the cookies in the category "Functional". |
cookielawinfo-checkbox-necessary | 0 | 11 months | This cookie is set by GDPR Cookie Consent plugin. The cookies is used to store the user consent for the cookies in the category "Necessary". |
cookielawinfo-checkbox-others | 0 | 11 months | This cookie is set by GDPR Cookie Consent plugin. The cookie is used to store the user consent for the cookies in the category "Other. |
cookielawinfo-checkbox-performance | 0 | 11 months | This cookie is set by GDPR Cookie Consent plugin. The cookie is used to store the user consent for the cookies in the category "Performance". |
viewed_cookie_policy | 0 | 11 months | The cookie is set by the GDPR Cookie Consent plugin and is used to store whether or not user has consented to the use of cookies. It does not store any personal data. |
Cookie | Tipo | Duração | Descrição |
---|---|---|---|
cookielawinfo-checkbox-analytics | 0 | 11 months | This cookie is set by GDPR Cookie Consent plugin. The cookie is used to store the user consent for the cookies in the category "Analytics". |
cookielawinfo-checkbox-functional | 0 | 11 months | The cookie is set by GDPR cookie consent to record the user consent for the cookies in the category "Functional". |
cookielawinfo-checkbox-necessary | 0 | 11 months | This cookie is set by GDPR Cookie Consent plugin. The cookies is used to store the user consent for the cookies in the category "Necessary". |
cookielawinfo-checkbox-others | 0 | 11 months | This cookie is set by GDPR Cookie Consent plugin. The cookie is used to store the user consent for the cookies in the category "Other. |
cookielawinfo-checkbox-performance | 0 | 11 months | This cookie is set by GDPR Cookie Consent plugin. The cookie is used to store the user consent for the cookies in the category "Performance". |
viewed_cookie_policy | 0 | 11 months | The cookie is set by the GDPR Cookie Consent plugin and is used to store whether or not user has consented to the use of cookies. It does not store any personal data. |
Cookie | Tipo | Duração | Descrição |
---|---|---|---|
cookielawinfo-checkbox-analytics | 0 | 11 months | This cookie is set by GDPR Cookie Consent plugin. The cookie is used to store the user consent for the cookies in the category "Analytics". |
cookielawinfo-checkbox-functional | 0 | 11 months | The cookie is set by GDPR cookie consent to record the user consent for the cookies in the category "Functional". |
cookielawinfo-checkbox-necessary | 0 | 11 months | This cookie is set by GDPR Cookie Consent plugin. The cookies is used to store the user consent for the cookies in the category "Necessary". |
cookielawinfo-checkbox-others | 0 | 11 months | This cookie is set by GDPR Cookie Consent plugin. The cookie is used to store the user consent for the cookies in the category "Other. |
cookielawinfo-checkbox-performance | 0 | 11 months | This cookie is set by GDPR Cookie Consent plugin. The cookie is used to store the user consent for the cookies in the category "Performance". |
viewed_cookie_policy | 0 | 11 months | The cookie is set by the GDPR Cookie Consent plugin and is used to store whether or not user has consented to the use of cookies. It does not store any personal data. |
Cookie | Tipo | Duração | Descrição |
---|---|---|---|
cookielawinfo-checkbox-analytics | 0 | 11 months | This cookie is set by GDPR Cookie Consent plugin. The cookie is used to store the user consent for the cookies in the category "Analytics". |
cookielawinfo-checkbox-functional | 0 | 11 months | The cookie is set by GDPR cookie consent to record the user consent for the cookies in the category "Functional". |
cookielawinfo-checkbox-necessary | 0 | 11 months | This cookie is set by GDPR Cookie Consent plugin. The cookies is used to store the user consent for the cookies in the category "Necessary". |
cookielawinfo-checkbox-others | 0 | 11 months | This cookie is set by GDPR Cookie Consent plugin. The cookie is used to store the user consent for the cookies in the category "Other. |
cookielawinfo-checkbox-performance | 0 | 11 months | This cookie is set by GDPR Cookie Consent plugin. The cookie is used to store the user consent for the cookies in the category "Performance". |
viewed_cookie_policy | 0 | 11 months | The cookie is set by the GDPR Cookie Consent plugin and is used to store whether or not user has consented to the use of cookies. It does not store any personal data. |
WhatsApp us