Post by account_disabled on Jan 31, 2024 6:18:15 GMT -5
Because it was not the pregnant woman's "whim", a health plan was ordered to reimburse a couple for the costs of the birth that took place at their home. The decision was made by judge Sang Duk Kim, from the 7th Civil Court of São Paulo. The woman had scheduled the birth at a hospital. However, due to an emergency situation, the child ended up being born at her home, following medical recommendations. After the incident, the couple asked the health plan for expenses to be reimbursed. Based on a contractual clause that excludes any professional healthcare assistance in the home environment from coverage, the health plan refused the reimbursement request.
Represented by lawyers Rafael Macedo Pezeta and Buy Phone Number List Cristina Madruga Dinamarco , from Falletti & Penteado Advogados, the couple then filed a lawsuit to have the health plan ordered to pay reimbursement in the amount of R$9,000, in addition to compensation for moral damages. When judging the case, judge Sang Duk Kim understood that reimbursement was appropriate in this case as the home birth occurred for an emergency and with medical recommendation. "This birth was due to an express medical indication due to the emergency circumstances of the birth. It was not a whim of the woman in labor”, he stated.
Citing the Consumer Protection Code, the judge concluded that the contract clauses should be interpreted in a manner more favorable to the consumer. The judge also noted that the costs of home births are often greater than those spent on hospital treatments. Thus, the judge ordered the refund, respecting the contractual limit of R$7,300. The request for moral damages was denied by the judge as he understood that there was no bad faith on the part of the health plan.
Represented by lawyers Rafael Macedo Pezeta and Buy Phone Number List Cristina Madruga Dinamarco , from Falletti & Penteado Advogados, the couple then filed a lawsuit to have the health plan ordered to pay reimbursement in the amount of R$9,000, in addition to compensation for moral damages. When judging the case, judge Sang Duk Kim understood that reimbursement was appropriate in this case as the home birth occurred for an emergency and with medical recommendation. "This birth was due to an express medical indication due to the emergency circumstances of the birth. It was not a whim of the woman in labor”, he stated.
Citing the Consumer Protection Code, the judge concluded that the contract clauses should be interpreted in a manner more favorable to the consumer. The judge also noted that the costs of home births are often greater than those spent on hospital treatments. Thus, the judge ordered the refund, respecting the contractual limit of R$7,300. The request for moral damages was denied by the judge as he understood that there was no bad faith on the part of the health plan.