• JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
 
  Bookmark and Share
 
 
Master's Dissertation
DOI
https://doi.org/10.11606/D.2.2016.tde-19082016-131015
Document
Author
Full name
Luciana Mayumi Sakamoto
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2016
Supervisor
Committee
Scaff, Fernando Campos (President)
Morsello, Marco Fabio
Puschel, Flavia Portella
Title in Portuguese
O modelo de pós-pagamento nos contratos de plano de saúde e a viabilização do direito de extensão do benefício pós-emprego
Keywords in Portuguese
Assistência à saúde
Benefício pós-emprego
Contribuição
Ex-empregado
Extensão do plano de saúde
Manutenção no plano de saúde
Plano de saúde coletivo empresarial
Princípios contratuais.
Seguro saúde
Abstract in Portuguese
A presente dissertação analisa a origem e a aplicação do direito de manutenção do ex-empregado no plano de saúde coletivo empresarial depois do seu desligamento da empresa. Nela, abordaremos a natureza do contrato de plano de saúde no ordenamento jurídico brasileiro e os seus efeitos mutantes no decorrer do negócio jurídico celebrado entre a estipulante, que é a empresa, a operadora de plano de saúde, que é a contratada, e o terceiro, que, na qualidade de empregado da empresa, é o beneficiário do contrato. Também analisaremos as características do sistema de saúde misto adotado no Brasil. Verificaremos que o direito de extensão do plano de saúde pós-emprego foi espelhado na legislação americana. Na legislação brasileira, contudo, esse direito teve suas características alargadas, de modo a ampliar o acesso à assistência privada e assegurar ao ex-empregado a sua permanência no plano de saúde. Por fim, abordaremos as bases principiológicas do direito à saúde, bem como os entendimentos doutrinários e jurisprudenciais que amparam a aplicação desse benefício pós-emprego, buscando soluções para a viabilização do direito considerando as suas peculiaridades no tocante aos aspectos econômicos desse contrato. Por ser uma fonte de direito relevante na atualidade, analisaremos por fim o papel da atividade jurisdicional e o método hermenêutico utilizado pelos magistrados para solucionar os litígios. Nosso argumento consiste em que o equilíbrio do contrato é essencial para a sustentabilidade da relação jurídica ora analisada.
Title in English
The post-payment model in healthcare plan contracts and how post-employment extension of this benefit may be implemented
Keywords in English
Contractual principles.
Contribution
Corporate Healthcare Plan
Former Employee, Extension of the healthcare plan
Health Insurance
Healthcare
Maintenance in the healthcare plan
Post-Employment Benefit
Abstract in English
The following essay examines the origin and the enforcement of the former employee maintenance right in the corporate healthcare plan after his dismissal or retirement. We will examine the nature of the healthcare contract in view of Brazilian legal system and its variable features during the transaction between the policyholder, which is the company that offers the healthcare plan to its employees, the contractor, which is the insurance company, and the third-party, which corresponds to the former employee, that is the beneficiary of the healthcare plan. Also we will analyze the characteristics of the Brazilian health system, which involves the public and private sectors. We will verify that the right that allows the extension of the healthcare plan post-employment was based on the American system. Under Brazilian law, however, this right was slightly changed in order to expand its applicability to allow the access to the private healthcare and to ensure the maintenance of the former employee in the corporate healthcare plan. Finally, we will discuss the principles applied to the right to health as well as the doctrinal and jurisprudential understandings that support the application of post-employment benefit, seeking solutions for the viability of this law, considering their peculiarities with regard to economic aspects of the agreement. It is also important to bear in mind that to solve the disputes filed prior to the Court, we have to analyze the role of the judiciary and the hermeneutical method used by judges to be applied on this matter. Our argument is that the contract balance is essential for the sustainability of the legal relationship.
 
WARNING - Viewing this document is conditioned on your acceptance of the following terms of use:
This document is only for private use for research and teaching activities. Reproduction for commercial use is forbidden. This rights cover the whole data about this document as well as its contents. Any uses or copies of this document in whole or in part must include the author's name.
dissertacao.pdf (1.59 Mbytes)
parcial.pdf (169.20 Kbytes)
Publishing Date
2016-11-01
 
WARNING: Learn what derived works are clicking here.
All rights of the thesis/dissertation are from the authors
CeTI-SC/STI
Digital Library of Theses and Dissertations of USP. Copyright © 2001-2024. All rights reserved.