Health plans have the right, as regulated by the Health Plan Law (9.656/1998), to suspend or cancel consumers' contracts in cases where fraud or non-payment of monthly fees is proven for a period of more than 60 days, consecutive or not. The Health Plans Act also states that operators can charge for the time the service was available to beneficiaries, even if they did not use the services offered. Here it is considered that even without use, the insured could have had access to the emergency room.
Non-payment of bills by the consumer does not lead to automatic cancellation of services. Given this fact, on the fiftieth (50th) day of non-payment, the insurer sends a notice to the insured person's address about the cancellation of the plan, due to the unpaid installments. Once this has happened, the consumer has the option of paying the overdue credits and continuing to use the health plan or not, but this does not prevent the operator from collecting the overdue monthly payments.
If it is in the interests of the insured person to cancel the service, this decision must be duly communicated to the health plan, i.e. the request must be formalized in writing, by means of a termination document that the plans have.
This is the only way for health insurance companies to know the consumer's intention. Without communicating the intention to suspend services, charges for monthly arrears become legitimate.
