Multas em tutelas judiciais de urgência contra Operadoras de planos de saúde suplementar
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Data
2017-12-07
Autores
Tanaka, Auro Hadano
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
A dissertação faz uma breve análise sobre a estrutura da fixação e execução das astreintes como instrumento garantidor da eficácia das tutelas de urgência emanadas em demandas judiciais envolvendo a recusa na prestação de serviços por parte de empresas operadoras de planos de saúde suplementar. Trata-se, pois, de importante ferramenta de garantia de um direito garantido constitucionalmente: a saúde. A ineficiência do Estado em provê-la, ainda que minimamente, só fez aumentar a procura por serviços de saúde suplementar, os quais, embora recebam contraprestação para tanto, vêm ao longo dos anos diminuindo consideravelmente a qualidade dos serviços e ocasionando com isso aumento exponencial de ações judiciais contra as operadoras de planos de saúde. Referidas ações buscam garantir a cobertura de despesas com medicamentos, tratamentos médicos hospitalares e até mesmo internações de urgência, situações que colocam em risco a saúde e a vida dos segurados. A fixação de multas (astreintes), como instrumento de coerção para o cumprimento das ordens judiciais de urgência, não têm sido suficientes para forçar o cumprimento das decisões. Ainda que o Código de Processo Civil de 2015 tenha autorizado a execução provisórias dessas multas, é necessário observar alguns critérios importantes no momento sua fixação e de sua execução, a fim de torna-las eficientes instrumentos de garantia dos direitos dos cidadãos e de uma ordem social mais justa.
The dissertation makes a brief analisys about the structure of the establishment and execution process of the astreintes as an enforcer instrument of the urgent relief issued in judicial procedures involving the refusal to render services by the supplementary health care providers. This is an important tool to guarantee a constitutional right: health. The State has been inefficient to provide the minimum conditions of public health services, and that has increased the search for supplementary health services. Thus, even against insurance premiums payments for rendered services, there has been a declining in the quality of the supplementary health care providers services, that has caused an exponential increase of law suits numbers against supplementary health care providers claiming the payment of expenses with remedies, medical and hospital treatments and even urgent hospitalizations, placing at risk the life and health of the insured persons. The establishment of fines (astreintes), as a coercion instrument to force the compliance of the urgent relief orders has not being enough to make these decisions to be obeyed. Even though the Civil Procedure Code of 2015 has authorized the provisory execution of theses fines, it is necessary to observe some important issues in the moment that they are being settled and by the time of its execution, in order to make them important instrument of guarantee of the citizens’ rights e of a more just social order.
The dissertation makes a brief analisys about the structure of the establishment and execution process of the astreintes as an enforcer instrument of the urgent relief issued in judicial procedures involving the refusal to render services by the supplementary health care providers. This is an important tool to guarantee a constitutional right: health. The State has been inefficient to provide the minimum conditions of public health services, and that has increased the search for supplementary health services. Thus, even against insurance premiums payments for rendered services, there has been a declining in the quality of the supplementary health care providers services, that has caused an exponential increase of law suits numbers against supplementary health care providers claiming the payment of expenses with remedies, medical and hospital treatments and even urgent hospitalizations, placing at risk the life and health of the insured persons. The establishment of fines (astreintes), as a coercion instrument to force the compliance of the urgent relief orders has not being enough to make these decisions to be obeyed. Even though the Civil Procedure Code of 2015 has authorized the provisory execution of theses fines, it is necessary to observe some important issues in the moment that they are being settled and by the time of its execution, in order to make them important instrument of guarantee of the citizens’ rights e of a more just social order.
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Palavras-chave
Direitos fundamentais, Efetividade, Exigibilidade, Tutela de urgência, Plano de saúde, Execução, Astreintes, Fundamental rights, Effectiviness, Collectability, Injunctive relief, Health plan, Enforcement