A mediação nos conflitos sobre o rol de procedimentos de cobertura em planos de saúde

Abstract

The purpose of this Master's Dissertation is to study one of the extrajudicial methods for conflict resolution, Mediation, which will seek to demonstrate its effectiveness, efficiency in resolving the conflicts of a modern and current society, which cannot and should not wait for slowness of our judiciary, which has not been able to serve everyone in the minimum expected time, due to the number of cases. We will focus on conflict resolution with regard to Health Plans and the list of procedures that deny coverage to the patient, where the Consumer, a low-sufficient part of the relationship, needs access to justice, a right protected by the Federal Constitution, since in most of them do not have the financial means to afford the fees of a lawyer, nor as the legal costs that they need for this type of legal claim. The need for institutional dialogue between those involved is essential in order to arrive at a fair solution for all. Therefore, it is essential, which is the responsibility of the ANS Regulatory Agency, the National Supplementary Health Agency, its applicability and inspection. We still seek, without the intention of exhausting the matter, to demonstrate the relevance of Mediation in our country, an institute that is gaining more and more worldwide prominence.