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Family Receives Compensation After Health Plan Is Canceled Without Notice! Court Decision Guarantees R$ 12 Thousand for Damages Caused by Unexpected Interruption of Service
The 4th Private Law Chamber of the Court of Justice of Ceará (TJCE) ruled that Unimed Fortaleza must pay R$ 12 thousand in moral damages to a family whose health plan was canceled without prior notice. The improper cancellation of the health plan occurred due to registration issues, and the decision was made on January 28, under the report of Judge José Evandro Nogueira Lima Filho.
Family Faces Difficulties After Improper Cancellation of Health Plan Due to Registration Issues
The case began in October 2022, when the family, which had been a beneficiary of the health plan since 2013, needed to change the registered CNPJ. According to the TJCE, the health plan operator informed that the alteration could only be made six months after the creation of the new CNPJ.
However, after this period elapsed, the clients attempted to regularize the documentation but received a notification alleging irregularities in the registration, which led to the cancellation of the health plan. In light of this situation, the family sought clarifications from Unimed Fortaleza, which claimed that it was necessary to keep the old CNPJ to continue the contract. However, this was impossible as the CNPJ no longer existed.
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Court Orders Payment of R$ 12 Thousand for Improper Cancellation of Health Plan
With family members needing continuous medical care, the clients filed a lawsuit to restore the health plan coverage and request compensation. Initially, the court granted a preliminary decision requiring Unimed Fortaleza to restore the health plan.
The operator, in turn, defended itself by arguing that the cancellation of the health plan occurred due to registration irregularities and default for over 60 days. However, the 21st Civil Court of Fortaleza, in July 2024, found that the company did not provide evidence to substantiate this default and also failed to notify the clients within the legal timeframe.
Based on these facts, the court decided to maintain the injunction and sentenced Unimed Fortaleza to pay R$ 12 thousand in damages caused to the family.
TJCE Reaffirms That Collective Plans with Fewer Than 30 Members Cannot Be Terminated Without Justification
Even after the decision, Unimed Fortaleza appealed to the Court of Justice of Ceará, but the TJCE rejected the appeal and upheld the ruling. The court emphasized that the notification regarding the alleged irregularities in the registration was only sent after the termination of the contract, characterizing the improper cancellation of the health plan.
Furthermore, the judges noted that under current legislation, collective plans with fewer than 30 beneficiaries cannot be terminated without a valid justification and without adhering to the deadlines set by law. Thus, Unimed Fortaleza was required to maintain health plan coverage and compensate the affected clients.
Impact of Decision on the Relationship Between Consumers and Health Plan Operators
The TJCE decision strengthens consumer protection against the improper cancellation of health plans by operators. Such situations have become recurrent in Brazil, where many families are harmed by unilateral terminations and lack of transparency in contract management.
The condemnation of Unimed Fortaleza serves as an example for other companies in the sector, demonstrating that non-compliance with regulations can result in financial penalties and the obligation to maintain assistance to beneficiaries. The R$ 12 thousand compensation awarded to the family also highlights the importance of consumers seeking their rights in court when they feel wronged.
With this ruling, it is expected that health plan operators will adopt stricter measures to ensure proper communication with their clients, avoiding abrupt cancellations without justification. This case reiterates the need for greater oversight in the sector and the importance of respecting consumer rights.
Source: Diário do Nordeste
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