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Ruling Reinforces Consumer Protection and Guarantees R$ 10,000 for Emotional Distress After Cancellation That Left Family Without Coverage at Delicate Moment
The 5th Chamber of Private Law of the Court of Justice of Mato Grosso upheld the conviction of a health plan operator for improperly canceling the contract linked to a high-risk pregnancy.
The result was the maintenance of the payment of R$ 10,000 for emotional distress, with a unanimous vote, in addition to the acknowledgment that the situation caused real insecurity for the family.
The case draws attention because the cancellation occurred when there was a risk of the consumer being left without medical assistance during a sensitive period, which goes beyond everyday inconvenience.
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What Happened and Why It Gained Attention
The operator unilaterally canceled the contract, leaving the policyholder and their dependents without coverage, including a woman in high-risk pregnancy.
The first-instance court ordered the immediate reactivation of the plan and set compensation for emotional distress.
The case analysis highlighted that the loss of coverage, in a vulnerable situation, can cause anguish and fear of discontinuity of care.
How the Contract Was Canceled and the Immediate Impact
The plan beneficiary was dismissed without cause and formally communicated, within the legally stipulated timeframe, that they wished to continue with the contract.
The continuation involved the full payment of premiums by the beneficiary, maintaining coverage for themselves and their dependents.
Even with this statement, the contract was terminated, which put the family at risk of being without medical support at the most delicate moment.
Who Has the Right and What Does Law 9.656/1998 Say
The decision acknowledged the regular exercise of the right to remain in the plan, as provided in Law 9.656/1998 for workers dismissing without cause.
When this right is respected, the continuity of the bond depends on the full payment of premiums, without interruption of coverage under the applicable terms of the contract.
The understanding was that the cancellation was irregular and generated insecurity, directly affecting consumer protection in a vulnerable situation.
Why the Court Considered Emotional Distress
The assessment was that it was not merely a simple annoyance, because the cancellation exposed a pregnant woman in high risk to uncertainty about the continuation of medical care.
In such situations, emotional distress is acknowledged when the conduct causes significant suffering and anguish, especially given the risk to health.
The rapporteur, Judge Sebastião de Arruda Almeida, noted that the compensation took into account the family’s vulnerability and the size of the company.
Why the Amount of R$ 10,000 Was Maintained
The panel understood that R$ 10,000 meets the criteria of adequacy and proportionality in the specific case.
The amount was seen as sufficient to compensate for the distress suffered and also to discourage similar practices by the operator.
The vote was unanimous, fully maintaining the conviction for emotional distress.
What May Happen From Now On
The decision reinforces that cancellation without support, in a vulnerable context, can lead to conviction and obligation to repair.
For those facing a similar situation, the key point is that the communication of continuation, when made within the timeframe and with the assumption of full payment, must be respected.
In addition to the reactivation of the plan when applicable, compensation for emotional distress may apply when there is real risk and significant suffering.
The maintenance of the conviction by the Court of Justice of Mato Grosso confirms that the breach of contractual good faith in a critical moment is not treated as a mere inconvenience.
In the end, the case leaves a practical message, that irregular cancellations during sensitive periods, such as high-risk pregnancy, can lead to compensation and other judicial determinations.
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