Consumer rights and solidary responsibility in improper refusal of coverage in emergency parties analysis of Special Appeal nº 1.947.757-RJ

Abstract

The present research focuses on the joint liability between health plan operators and affiliated hospitals in cases of undue denial of coverage for emergency childbirth, based on the Consumer Defense Code and the jurisprudence of the Superior Court of Justice. Its purpose is to determine whether, based on the Consumer Defense Code and the jurisprudence of the Superior Court of Justice, it is possible to establish the joint liability of health plan operators and affiliated hospitals in cases of undue denial of coverage for emergency childbirth. Objectives: The general objective is to analyze this joint liability, based on the CDC and the jurisprudence of the Superior Court of Justice. Specifically, the study aims to: identify the principles and norms of the CDC that support this liability; investigate the jurisprudence on health plan contracts in emergency cases; and examine the specific understanding of the same higher court in Special Appeal No. 1.947.757 - RJ. Method: The methodology adopted is qualitative, involving bibliographic review, documentary, and jurisprudential analysis, focused on the study of the aforementioned appeal. Results: The results indicate that the denial of coverage for emergency childbirth violates the right to health, justifying the application of joint liability, allowing the consumer to seek compensation from any party involved in the service delivery chain. Additionally, the study considers the relevance of integrating health law norms into the consumer code to maximize protection for consumers, especially in vulnerable situations such as pregnancy complications. Conclusion: It is concluded that a robust interpretation of the Consumer Defense Code, combined with the jurisprudence of the Superior Court of Justice, is essential to ensure the legal protection of pregnant women, reinforcing the importance of an integrated approach between consumer law and health law.