Safe. Health. Restrictions. VALUE. Archived on: Civil - Bonds and contracts, the consumer, abuse, Insurance, Health Insurance

This is combined with the compensation declaratory action filed by the insured property which aims to remove the clause is considered as unfair in the health insurance contract. They described the case that the insurance does not cover hospitalization costs after the exit of the insured who suffered from attacks of hypertension, and transferred to hospital in a coma with a diagnosis of cerebrovascular accident (CVA). Action in the court upheld that part of the class 1 on the reform of the Court a quo, which is regarded as healthy women to limit the application of the value of expenditure (only UFESP 2895) in the contract. The heirs, in Resp, they rebelled against the decision. In this particular example, emphasizes Min. Rapporteur, as there is no appeal against the insurance, further controversy about the terms of the insured in the contract the disease, that because both courts concluded that no ordinary case of diagnosis of hypertension explanations that lead to crisis and inpatient transfer, which explains why the insurance can not be a reason himself from coverage. Also noted that the hypothetical case is not one already established in the Sum. No 302-STJ (considered rude contract clause that limits hospital length of the insured). He stood out that the restrictions imposed under clause value is more crude than the conclusion involves the assumption of equal treatment, or even worse, because it would not be logical nor legal nor medical science to determine the time and the recovery needs of the patient's contract. Therefore, he warned me. Rapporteur that the provision of art. 13 of Decree No. 73/1966 prohibits insurance clause that eliminates the effectiveness and validity beyond the cases provided by law (CDC). Eventually, the words carry a sentence in connection with the provision to limit the scope, indicate that while the insured is older (more than sixty-five years) have higher costs and an additional 15% fee as required by the policy, coverage limits are not increased, indicating imbalance between the supply of the elderly and the roof of an insurance company, so that the insured pay more for the parents represent a greater risk, but the limit is unique for all ages, representing a loss that does not make sense in the consumer, as happened in the file. Given above, upheld the appeal to restore the class from the first sentence.

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