ES patient prevented from consulting must be compensated by health plan in R$ 10 thousand

Photo: Orzalaga/Pixabay

A patient who was prevented from seeing a neurologist in a hospital in Vila Velha must be compensated in R$ 10 thousand for a health plan. The case happened when the patient was already in the doctor’s office and was surprised by an attendant, saying that he should leave the place because his plan had denied authorization for the procedure.

The man said that, before the event, he had filed a lawsuit in order to review the abusive increase in tuition, which is why the deposits to the defendant were being made in court. Despite this, according to him, several charges were still made.

After leaving the office, the patient demanded that the hospital call the health plan, which authorized the consultation, however, as the system does not support the judicial payment method, there is an automatic block, and it is not possible to access the patient’s medical history. patient.

The man said he was upset by the humiliation he suffered in front of the doctor, hospital staff and other patients.

On the other hand, according to the State Court of Justice, the health plan claimed that at no time did it suspend the agreement, it only recorded in the system the information that the author would make the deposits in court and, therefore, should seek authorization from the call center.

The judge of the 5th Civil Court of Vila Velha, responsible for the case, found that the health plan made it difficult to authorize consultations for the patient, since the system stated that there was a pending issue at the time of requesting the consultation, even with deposits being performed.

He also considered that the disorders experienced by the patient, each time he had to make an appointment, lasted a certain time. In view of this, compensation for moral damages was set at 10 thousand reais in favor of the patient.

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