SUPPLEMENTARY HEALTH AND CONSUMER PROTECTION: THE SUPERIOR COURT OF JUSTICE AS A PLAYER IN THE CONSTRUCTION OF PUBLIC POLICIES

Abstract

This paper aims to examine the main controversies faced and precedents set by the Superior Court of Justice in recent years regarding the subject of health insurance or health plan contracts. To this end, this paper analyzed 9 (nine) jurisdictional decisions regarding obligations involving health plans, issued by the STJ between 2023 and 2024, which were highlighted in case law bulletins published by the Court. The study examined the STJ's understanding regarding the following issues related to the subject of research: abusive practices in promoting adjustments in the health plan contract; obligation to supply medicines in consideration of the list of procedures and events of the National Supplementary Health Agency (ANS); obligation to supply medicines for home treatment; healthcare coverage for newborns; and obligation to pay for the cryopreservation of eggs to prevent infertility resulting from cancer treatment. In the end, it was concluded that the Judiciary, and especially the STJ, has a relevant role as a player in the political arena for the construction of public policies for regulating health plans in Brazil, delimiting the scope and limits of the normative frameworks regarding this type of consumer relationship that constantly puts consumer rights and the interests of companies that maintain health plans on a collision course.