Post by account_disabled on Mar 6, 2024 3:12:29 GMT
Collective health plans are based on free negotiation between the contracting parties, and the National Supplementary Health Agency (ANS) is only responsible for monitoring the adopted rates, and not establishing an index as a ceiling.
Based on this understanding, the 10th Panel of the Federal Regional Court of the 1st Region (TRF-1) denied the request of the Regional Council of Engineering, Architecture and Agronomy to apply the 13.57% index as an adjustment to a collective health plan, under the terms provided for by ANS.
The council alleged in the action that the adjustment B2B Email List to the plan was abusive and exorbitant, in addition to having been established without prior notice.
Brazil Agency
10th Panel of the TRF-1 maintained the adjustment provided for in the contract signed by the parties
When analyzing the case, however, the rapporteur of the matter, federal judge Rafael Paulo Soares Pinto, noted that the plaintiff did not point out an error in the methodology used to measure the update index applied to the contract under discussion. The council's argument was based exclusively on the supposed onerousness of the index, having extrapolated the percentage of 13.57% predicted by the ANS in individual plans.
Regarding the adjustment, the judge considered that the contract signed by the parties had clauses that provided that the monthly amount could undergo legal and contractual adjustments.
It is also stated that the application of the indices approved by the ANS is restricted to individual contracts. In this way, the collective health plan is governed by the clauses of the contract signed between the parties, and the value of the monthly fee is established through parameters of the group served by the services, with adjustments being possible both due to the change in age group and the accident rate of the contract.
In light of this, the panel unanimously dismissed the appeal in accordance with the rapporteur's vote. With information from the TRF-1 press office.
Based on this understanding, the 10th Panel of the Federal Regional Court of the 1st Region (TRF-1) denied the request of the Regional Council of Engineering, Architecture and Agronomy to apply the 13.57% index as an adjustment to a collective health plan, under the terms provided for by ANS.
The council alleged in the action that the adjustment B2B Email List to the plan was abusive and exorbitant, in addition to having been established without prior notice.
Brazil Agency
10th Panel of the TRF-1 maintained the adjustment provided for in the contract signed by the parties
When analyzing the case, however, the rapporteur of the matter, federal judge Rafael Paulo Soares Pinto, noted that the plaintiff did not point out an error in the methodology used to measure the update index applied to the contract under discussion. The council's argument was based exclusively on the supposed onerousness of the index, having extrapolated the percentage of 13.57% predicted by the ANS in individual plans.
Regarding the adjustment, the judge considered that the contract signed by the parties had clauses that provided that the monthly amount could undergo legal and contractual adjustments.
It is also stated that the application of the indices approved by the ANS is restricted to individual contracts. In this way, the collective health plan is governed by the clauses of the contract signed between the parties, and the value of the monthly fee is established through parameters of the group served by the services, with adjustments being possible both due to the change in age group and the accident rate of the contract.
In light of this, the panel unanimously dismissed the appeal in accordance with the rapporteur's vote. With information from the TRF-1 press office.