Ex-employee with 10 years of service must be kept in plan

The worker is entitled to continue enjoying the corporate health plan if he has been a beneficiary for more than ten years. And the company must indemnify him if it excludes him from coverage even though he has expressed an interest in remaining on the plan after leaving his job.

Bradesco Saúde should keep former employee in business plan, court decides

Brazil Agency

Based on this understanding, the 31st Civil Court of Rio de Janeiro ordered Bradesco Saúde to maintain a former employee linked to the business plan of Banco Bradesco. In addition, it determined that the operator pay compensation for moral damages of R$ 5 thousand.

The banker, represented by the office Stamato, Saboya & Rocha Advogados Associadosasked to remain at Bradesco Saúde, demonstrating that he was an employee of Banco HSBC and that for more than ten years he contributed his quota monthly, before the acquisition of the company by Bradesco, which started to provide the plan in the form of co-participation.

Bradesco Saúde, in turn, argued that Law 9,656/1998 does not qualify co-participation as a contribution. Therefore, it does not guarantee such persons the right to remain in the business plan after leaving the company.

Judge Paulo Roberto Campos Fragoso, however, stated that article 31 of Law 9,656/1998 establishes that the former employee who contributed with the monthly health plan, as a result of an employment relationship, for a minimum period of ten years, is entitled to maintenance of the plan for life as a beneficiary, under the same conditions of assistance coverage that he enjoyed when the employment contract was in force, provided he assumes full payment.

For the judge, the fact that the service provision model and the form of funding have been changed does not imply interruption of the ten-year period provided for by law. Fragoso understood that it had been proven that the banker had made the contribution within the legal term. Therefore, he secured the right to maintain coverage as a beneficiary.

The judge also pointed out that the refusal of the former banker to remain in the plan was illegal. Thus, the insurer has a duty to indemnify you.

Click here to read the decision
Process 0089434-60.2021.8.19.0001

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