Health plan is condemned for readjustment of 79% in monthly fee for elderly

Judge of Law Jose Fabiano Camboim de Lima, from the 8th Civil Court of São Paulo/SP, condemned a health operator for readjusting the elderly woman’s monthly fee by 79% when she turned 70. According to the magistrate, by allowing unreasonable increases without previous contractual provision, the applied adjustment puts the consumer in contractual imbalance.

The elderly woman, beneficiary of a health plan contract, went to court against the age adjustment imposed by the operator, when she turned 70. She narrated that the increase was illegal and unfair, as it constitutes discrimination against the elderly. In this sense, it requested the declaration of nullity of the contractual clause that determined the readjustment. In defense, the health operator maintained the regularity of the adjustments applied.

When analyzing the case, the magistrate found that the contract concluded between the parties “provides for age groups for adjustments, however, it does not provide for the percentage of adjustment to be applied, not allowing the insured to know what the variation in the premium value will be due to the change in age group”.

“The contract signed between the parties is subject to the rules of the CDC, which provides, as a basic consumer right, the modification of contractual clauses that establish disproportionate benefits or their revision due to supervening facts that make them excessively onerous.”

  (Image: Freepik)

Health operator is convicted of abusive readjustment in the elderly’s monthly fee. (Image: Freepik)

In the judge’s understanding, the readjustment percentage applied due to the age group over 70 years old is abusive, as it puts the consumer in contractual imbalance by allowing unreasonable increases without previous contractual provision. “The contested readjustments are abusive and null and void”he concluded.

Finally, the judge upheld the request to declare the readjustment applied null and void, and only the annual readjustments authorized by the ANS should apply.

The office Firozshaw Lawyers works in the cause.

Read the sentence.

Firozshaw Lawyers

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