A health affiliate was diagnosed with grade 1 diabetes and initiated the procedures so that its prepaid recognizes 100 percent of the treatment and medicines.
• In this regard, lawyer Pablo Pagnone informed Apfdigital that, given the response that only one part would recognize, legal actions were initiated
• Justice decided to prioritize the right to life and health over the legislation in which the company was protected and ordered the total coverage requested by the plaintiff
According to Pagnone: “The local Medicine company, CEN Salud, is located in the Santa Lucía neighborhood and attends only in Paraná.Before the requirement of a client of more than eight years old for the provision of medicines and supplies that have to do with diabetes because she was diagnosed with diabetes 1, that is, insulin of the dependent, they deny her the benefit under the argument that she is exemptedfor being a company that provides coverage up to five thousand affiliates.Therefore, they offered my client 20 percent of the value of inputs and medicines for both treatment and control. ”
"We intimidated him, they did not respond to us and that is why we went to the justice based on the fact that there is a norm that forces the total coverage of the diabetic patient by the health company that provides the coverage."
Specifically, the plaintiff eight years ago who is affiliated and in January of this year the disease was diagnosed.He performed the relevant administrative steps to supply the medications but the prepaid only replied that he would cover him 20 percent and, at the conciliation hearing held in March, he rose to 50 percent.
The woman is covered by Law No. 23,753, which provides "the coverage of medicines and diagnostic reagents for self -control of patients with diabetes, will be one hundred percent and in the necessary amounts according to medical prescription."
For its part, the prepaid says that Law No. 26.682 "authorizes prepaid medicine companies to develop their activities within a town and have less than five thousand affiliates, to offer health plans with partial coverage."
However, justice prioritized the first of these rights.“It is a case that must sit on two issues, first because it allows action against the prepaid medicine company in local justice, unlike social works that must be resorted to the Federal Court, and secondly, the right toLife and therefore to health over the right to the economic revenue that has a particular company that pursues a profit, ”the lawyer told this agency.
Therefore, justice resolved "to make the Amparo Action" and consequentN kwkpen, penalty x3 x5;1 box of 50 reactive strips brand ACCU-CHEL PERFORMA;a box of 50 reactive strips brand ACCU-Chek Perform;1 box of 24 brands brand CCU Chel Fastclix Lancets;1 box of 100 needles Novo Fine 32 g;In addition to 90 monthly metaformin tablets 850 mg.(any laboratory) and 90 monthly groceries of 5mg glylamid”
Finally, the lawyer said that the ruling, which is dated March 14, "is already firm and spoiled."(APFDIGITAL)
