Prevent a prepaid tariff up older members
Monday, November 14th, 2011The House banned automatic increases to those meeting 65 or 70 years and noted that the clause stating that additional increase is unfair
Division II of the House Civil and Commercial Federal had upheld a ruling that ordered the company prepaid medical CEMIC refrain from increasing the quota based on the member’s age, this is that the older the higher the fee.
In case, the trial judge had said that “increased support established in the member’s age is intended to make it more onerous fees for those who for their personal reality, they become part of the areas most vulnerable, usually composed for retirees with a significant decrease in revenues, just when they most need of medical service contract, “the Judicial Information Center (ICJ).
On appeal, the company had argued, among other things, that “the current system be modified in all prepaid medical institutions, the higher cost to generate the many benefits to be given to persons who reach 65 and 70, should be moved to the price of membership fees for the remaining members who are not in that stage of life and usually require less care. ”
According to the maid Alfredo Gusman, James Kiernan and Richard Guarinoni, “the link is established between the medical company and the long-term partner is, therefore, in general, the marginal utility curve of the parties is reversed … From there that ‘the consumer makes a financial investment when young, when you have a certain solvency or when healthy, to be compensated when you reach old age or when they have money or lack of health.’ ”
They also noted that “this is an aleatory contract because the parties do not know if they will be required medical services or not, which depends on an event that is the disease … Thus, ‘the insurer is entitled to spread the risks in terms of a probability calculus but not move them without taking any … randomness is for both parties and a clause is not allowed to neutralize the risk, exclude or limit, if the alloy is in charge of one of the parties and the other has a certainty of winning, the clause is void. ‘”
“On this basis, is forced to conclude that the contractual clause that empowers the company to impose additional tariffs care by age is abusive … Thus, collides with Article 42 of the Constitution, in granting consumers the right to protect their health, safety and economic interests, as well as fair and dignified treatment, “they said.