Cancellation of 290 thousand health plans generates actions in the government and in the courts

“Companies want to sell. When the plan gives work, in a year’s time, they find a way to expel the customer”, says Norma Negrão, from the Consumer Protection Center of the Public Defender’s Office of Alagoas. “These are forged entities. It’s fraud”, corroborates defender Marco Paulo Denucci, from the Consumer Center in MG.

The operators deny it. The Brazilian Association of Health Plans says that “in no way was there any risk selection, a practice prohibited by the regulatory agency.”

The ANS allows terminations without the patient’s notice in collective membership plans, unless the patient is hospitalized or the treatment is considered essential to survival. But this is not being respected.

“He underwent three cardiological surgeries. He needs consultations with a pediatric cardiologist and regular exams. The urgency is a well-known fact”, wrote judge Paloma Barbosa, from the 3rd Civil Court of Águas Claras (DF), when reestablishing a child’s plan 7 years old.

“I was very shaken (with the termination of the plan, in May), because I can’t afford treatment of this level”, says Francisca Cleto Braga, mother of two autistic teenagers in Gama (DF). The family recovered the plan in court, but complains that Amil has now become more demanding in authorizing treatments and consultations.

ANS also conditions unilateral cancellations on migration to other plans without a waiting period. However, the cost may exceed double the canceled monthly fee.

“The plans I’ve been trying ask for (membership) to be with CNPJ (company), but the monthly fee would be very high. I would have to pay mine, my son’s… It’s more than R$5,000 per month. I’m unprotected”, says Célia Bertotti, 77, whose plan was canceled by Amil after breast cancer, which she is undergoing treatment for.

Amil stated that, “in relation to the beneficiaries listed in the report, all of them have active health plans”. This occurred after a court decision.

The operators Notredame, Sulamérica and Bradesco denied making unilateral terminations in membership plans. Notredame and Unimed Nacional said they did not adopt discriminatory cancellations. Unimed-Rio said it was committed to rules for terminating contracts.

The ANS stated that it does not have data on unilateral cancellations and that it resolves “around 90% of complaints registered on its channels”.