Banca de DEFESA: VALQUÍRIA FERREIRA DE FARIA

Uma banca de DEFESA de MESTRADO foi cadastrada pelo programa.
STUDENT : VALQUÍRIA FERREIRA DE FARIA
DATE: 28/04/2025
TIME: 10:30
LOCAL: https://teams.microsoft.com/l/meetup-join/19%3ameeting_NTVkNGFhMWUtMzhlMS00MGE3LWExMzgtY2Q5NzYxNGI0
TITLE:

NIP AS AN EFFECTIVE INSTRUMENT FOR THE EXTRA-JUDICIAL RESOLUTION OF CONFLICTS BETWEEN BENEFICIARIES AND OPERATORS OF PRIVATE HEALTH CARE PLANS

KEY WORDS:

ANS, beneficiary; NIP; operators; health plan.

PAGES: 122
BIG AREA: Ciências Sociais Aplicadas
AREA: Direito
SUMMARY:

The objective of this study is to demonstrate that the pre-trial and extrajudicial conflict mediation instrument developed by ANS is efficient from both a legal and regulatory perspective, since it provides a quick and effective response to consumers. In addition, it allows Private Health Insurance Plan Operators to cease any operational practices that are not in accordance with the legislation and promote voluntary and effective redress of conduct - RVE, avoiding the initiation of lengthy administrative proceedings and the application of penalties. Furthermore, the NIP contributes to the effective monitoring of the market by ANS. The aim is also to analyze the impacts of the NIP on the judicialization of supplementary health, since this tool for prior conflict resolution is increasingly used by beneficiaries, since it allows a faster and more efficient response to consumers potentially harmed by operators, than judicial proceedings that can last for a long time. The methodology used to achieve the proposed objective involves the analysis of supplementary health legislation, ANS's understandings and case law. The aim is to demonstrate how the supplementary health system works, the main characteristics of health plans and the constitution of operators and the termination of their activities. Furthermore, the ANS’s competence, the consensus in the Public Administration and how this administrative principle contributed to the implementation of the NIP will be discussed. The ANS’s administrative sanctioning process and the NIP procedure will also be analyzed. The research concludes that the NIP is an effective mechanism for the extrajudicial resolution of conflicts between beneficiaries and operators and, therefore, contributes significantly to the realization of the fundamental right to health. However, in order to continue exercising its mediating and conciliatory role, it is necessary to improve it to avoid distorting its purpose.

COMMITTEE MEMBERS:
Presidente - 1549538 - OTHON DE AZEVEDO LOPES
Interno - 2292593 - MARCIO NUNES IORIO ARANHA OLIVEIRA
Externo ao Programa - 1996968 - HENRIQUE ARAUJO COSTA - UnBExterno à Instituição - GABRIEL DE MELLO GALVAO - AGU