Good faith and refusal of recommended medical surgery

ATA/627/1998Tribunal de Justiça / Câmara Administrativa6 de out. de 1998

Extraído pela Omnilex

Resumo Omnilex

In an accident-insurance dispute, the claimant refused to undergo a valgus osteotomy recommended by the treating physicians and nonetheless sought continued indemnification. The court held that, in such circumstances, the claimant cannot invoke good faith to demand the continuation of benefits. The case concerns the insured person’s duty to accept reasonable medical treatment measures and the limits of continued compensation when cooperation is withheld.

Sumário Omnilex

Art. 6 LAA; refusal of a medically indicated operation and good faith entitlement to continued benefits: an insured person who declines a reasonable, physician-recommended intervention cannot invoke the principle of good faith to require the continuation of accident-insurance indemnification. The duty to cooperate with suitable medical treatment measures delimits the insured’s entitlement where the proposed intervention is reasonable and intended to restore or improve earning capacity or health (consid. unspecified).

Texto completo

Descripteurs

ASSURANCE SOCIALE; ACCIDENT; AA; PRINCIPE DE LA BONNE FOI; SOINS MEDICAUX; ASSU

Normes

LAA.6

Résumé

Le recourant qui ne se soumet pas à une intervention (ostéotomie de valgisation) préconisée par les médecins, ne saurait réclamer de bonne foi la poursuite de l'indemnisation.

Palavras-chave

social insuranceaccident insurancegood faithmedical treatmentsurgery refusalbenefits continuation

Extraído pela Omnilex

Questões jurídicas principais extraídas pela Omnilex

Questão jurídica principal

Whether a claimant who refuses a medically recommended valgus osteotomy may still demand continued compensation in good faith under accident insurance.

Decisão extraída

No. A claimant cannot rely on good faith to demand continued indemnification while refusing the recommended intervention.

Fundamentação extraída

The refusal of a recommended medical procedure breaks the basis for claiming continued benefits in good faith; the insured must cooperate with reasonable treatment measures.

Good faith and refusal of recommended medical surgeryGerado por IA