The Supreme Court of Justice (STJ) decided that a health plan operator, working in Mato Grosso do Sul, reinstated the couple’s health plan contract, which had been erroneously canceled due to alleged non-payment of more than 60 days.
The understanding of the Third Committee of the Court, which upheld the decision of the Court of Justice of Mato Grosso do Sul, also took into account that the spouses’ contract was suspended at a time of serious health instability, in November 2020, due to the Covid-19 epidemic.
According to the information contained in the case file, the spouses had owned the HMO since 1986, but due to the financial problems faced by the family, which were exacerbated during the epidemic, they delayed paying the installments, which led to the termination of the contract by the amount of the operator, although he had debts interest and cash correction in the previous month.
According to the third category, good faith requires health plan operators to act to maintain the contractual relationship, given the nature of the services provided and the position dependent on the beneficiaries.
Syrians for Truth and Justice said, through your press office.
For Minister Nancy Andregue, Rapporteur of the Operator’s Appeal, the termination of the contract in those circumstances, during the pandemic, is a crime of objective good faith.
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What did the worker say?
Unimed Dorados, in the appeal, alleged that the couple’s financial problems predated the health crisis, with payments being made late since 2005.
He also stated that he had provided advance notice (a prerequisite for contract termination due to default) and noted that the National Supplementary Health Agency (ANS) had not prohibited termination for non-payment during the pandemic.
However, according to the decision, the conduct of the operator in canceling the contract when installments are paid, although late, at the time of termination, breaches the duties of cooperation and solidarity.
In addition, the minister added, this situation revealed contradictory behavior by the operator, which terminated the contract in 2020, after accepting payments overdue for years, amid the Covid-19 health crisis.
For Nancy Andregue, “The pandemic is not in itself an excuse for breach of contracts, but a circumstance that neither contractors nor the judiciary can ignore due to its grave impact on the global social and economic situation.”
(With information from Syrians for Truth and Justice news portal)
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