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Master's Dissertation
DOI
10.11606/D.5.2017.tde-01082017-095624
Document
Author
Full name
Rafael Robba
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2017
Supervisor
Committee
Scheffer, Mário César (President)
Bdine Junior, Hamid Charaf
Coutinho, Diogo Rosenthal
Novaes, Hillegonda Maria Dutilh
Title in Portuguese
Judicialização dos planos e seguros de saúde coletivos no Tribunal de Justiça de São Paulo
Keywords in Portuguese
Decisões judiciais
Planos de pré-pagamento em saúde
Poder judiciário
Saúde suplementar
Seguro saúde
Sistema de saúde
Abstract in Portuguese
O estudo Judicialização dos planos e seguros de saúde coletivos no Tribunal de Justiça de São Paulo trata das ações judiciais relacionadas a planos e seguros de saúde coletivos, julgadas pela segunda instância do Tribunal de Justiça de São Paulo nos anos de 2013 e 2014. São descritas e analisadas as demandas levadas ao Poder Judiciário pelos consumidores de planos de saúde. Os conflitos envolvem coberturas, reembolso, aposentados e demitidos, reajustes aplicados sobre a mensalidade, cancelamento de contrato e descredenciamento de hospitais. Também são analisados o comportamento e as argumentações da Justiça nas decisões. Conclui-se pela necessidade de aprimoramento da regulamentação e da fiscalização das atividades dos planos e seguros de saúde
Title in English
The Judicialization of plan and collective health insurance study at the Court of Law of Sao Paulo
Keywords in English
Health insurance
Health systems
Judicial decisions
Judiciary
Prepaid health plans
Supplemental health
Abstract in English
The Judicialization of plan and collective health insurance study at the Court of Law of Sao Paulo treats legal actions related to plans and collective health insurances judged by the Court of Law of São Paulo of Second Instance in 2013 and 2014. It was described and analyzed the demands referred to Judiciary branch by health plan consumers. The conflicts involve coverage, reimbursement, retired and dismissed people, readjustments applied on the monthly payment, contract cancelling and hospital loss of accreditation. It is also analyzed the behavior and arguments of Justice on decisions. It is evidenced the need of improving the regulation and supervision of health plans and insurances
 
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RafaelRobba.pdf (5.63 Mbytes)
Publishing Date
2017-08-01
 
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