Contrato Empresarial Coletivo de Assistência à Saúde
AUTOR(ES)
Maria Eugênia Ferraz do Amaral Bodra
DATA DE PUBLICAÇÃO
2008
RESUMO
In an environment in which the market shows a substantial growth of the sale of group health insurance contracts for businesses and a significant surge in the sale of individual health insurance contracts, differently from what appeared to be the goal of the regulatory system established for the industry in 1998, this work deals with the economic and legal questions that surround this important area of healthcare law. Initially, a history of the legislation that governs the industry is presented. This is followed by a brief explanation of the complexity that characterizes the field of healthcare law and by the presentation of some economic data about the healthcare market in Brazil. Then, in light of the relevance of regulatory activity, there is an examination of the economic regulation of the healthcare industry, which finds that it is not legal to impose, on insurance companies, an obligation to contract for individual insurance at a preestablished price, as is argued by some scholars, to conclude at the end that proper economic intervention should result in the preservation of the equilibrium of two fundamental principles of the legal system: on the one hand, the free enterprise of the supplier and its legitimate interest in making a profit, and on the other hand, the legitimate respect for the consumer who should have access to quality medical services. Finally, the Group Health Insurance Contract for Businesses is analyzed, especially in regard to its most important and distinctive aspects, which are its clauses for readjustment for the occurrence of insurable events and for rescission for nonpayment, using the theory of contractual equilibrium and of relational contracts, both of which are defended by the most up-to-date private law, to conclude that these clauses are legal, through the relational model, which not only assures equilibrium between the parties but also goes beyond the single form of consumer contractual relationships studied up to that point, putting an emphasis on flexible procedures in which transparency and trustworthiness should prevail as the supreme values
ASSUNTO(S)
seguro-saude -- leis e legislacao -- brasil assistência à saúde health insurance contrato empresarial coletivo contratos -- brasil direito comercial contract fot business
