December 2, 2021

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TJRN specifies that Unimed Natal authorizes a surgical procedure in the elderly

TJRN specifies that Unimed Natal authorizes a surgical procedure in the elderly

Credits: AndreyPopov/iStock

The Second Civil Chamber of the Rio Grande do Norte State Court of Justice (TJRN) upheld the decision of the Fifth Civil Court of the Natal District and decided that the Maternity Cooperative for Medical Action, authorizes a replacement procedure that must be performed with an artificial aortic valve, according to the prescription, of a 73-year-old woman with Severe aortic valve stenosis and systemic arterial hypertension.

The decision was made in the Interlocutory Appeal Judgment (0807208-38.2021.8.20.0000), according to the reporter, Judge Maria Zined Bezerra, a doctor’s prescription has the presumption of necessity, especially when provided by consumer protection law and the right to life and dignity, of a constitutional nature, must prevail. , on any other rules in the organization or even in the contract.

Unimed Cuiabá readjusts the plan for the elderly by 113% and is indicted
Credits: B.Stefanov / Shutterstock.com

According to the judge’s vote, the surgical procedure mentioned in the application includes an express provision in Annex I of Normative Resolution No. 465/2021, regulating Law No. 9656/98.

And the rapporteur confirmed, in her words, that the risk of irreparable harm is indisputable, given the seriousness of the disease, “given that the delay in carrying out the described procedure can cause serious damage to the patient’s health.”

Indefinite health plan
Credits: yavdat / iStock

According to the ruling, the deadline (five days), which was corrected by the first instance judge, contrary to what was claimed by one of the operators, is not disproportionate, because for the university it is an elderly person, comorbidities and evidence of surgery.

With information from the Court of Justice of the State of Rio Grande do Norte.


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