Supplementary health insurance was born and grew sustained by the deficiency of the national public health care service, so that, in order to provide consumers with a guarantee for the prevention and treatment of diseases in general, the insurance market has brought one of the most complex insurance branch in the way it concerns to an extremely sensitive subject (life and health), being also one of the sectors most regulated by state organs, especially by the national agency of supplementary health. The available modalities to the consumer are health insurance and the health plan, considering that the crucial difference between them is the possibility of reimbursement of medical-hospital expenses, being a rule in the first while in the second, is exceptional, since in health insurance, the insured can choose the provider that best meets your needs, paying directly and later requesting a refund from the insurance company. On the other hand, in the health plan, usually, the consumer is served in an accredited institution, where he will not bear expenses.
Supplementary health insurance is aimed to the entire population as well as to legal entities, giving the option of several types of hiring, which can be individual, for family and employees, etc. In addition, the type of insurance coverages are diversified and commonly grouped by age group, leading to older ones a considerably greater financial burden compared to younger people; however, other factors, such as medical and dental services and even geographic location may directly influence supply.
Given the nature of the insurance, aimed for the health of the insured, many of the demands placed on these contracts stem precisely from the negative sustained by the insurer when requested to authorize the performance of certain medical procedures that the contractor believed to have coverage. Therefore, our office is able to act in pursuit of the interests of the client, according to the strictest legal and contractual dictates, in order to ensure a correct application of the contract.
The insurance inherent to the supplementary health sector have great relevance and a high volume of insureds and insurers in the national market, due to the fact of the constant search of the consumers for medical and dental services of attractive quality and cost. Thus, as the consumer seeks a specialized medical service, it is important to the operators of the branch an adequate legal assistance, since it involves, in addition to the medical specificities, many highly significant legal aspects.