The dilemma of breast prosthesis coverage by health care insurers and the extension of the effects of REsp No. 1.733.013

Abstract

Aesthetic surgeries in Brazil have gained the spotlight in recent years, especially mammoplasties, drawing the attention of health insurance companies on how this could affect their contractual relationships. However, plastic surgery can have a restorative nature when necessary for health treatment. In this scenario, interpretative conflicts arise from the contractual clauses and the dimension of civil liability of the agents involved in this procedure, especially after RESP 1.733.013, which aims to comprehensively interpret the ANS List.