Home care: medical prescription as a guiding element for conflict resolution Rodrigo Trisoglino Nazareth

Abstract

The purpose of this study is to analyze the so-called home-care (home medical care), addressing the conflicts between health plan operators and consumers. This is a descriptive and propositional investigation that aims to explain the reasons for different positions: whether or not coverage is due. For the collection, bibliographic and documentary research is used. The discussion concerns the contractual exclusion of coverage and the reflection on abusive clauses and those contrary to objective good faith and the social function of the contract. A systematic interpretation of the Consumer Defense Code and Law 9.656/98 is proposed in order to protect the interests of health plan beneficiaries. The conclusion is that, along with the consumer protection system, the medical prescription has been the preponderant and decisive factor for the success of lawsuits of this nature, according to current case law.