In August 2023, the Superior Court of Justice (STJ) ruled that health insurance companies are obliged to pay for a procedure to cryopreserve the eggs of cancer patients[1], as a preventive measure against the risk of infertility, until they are discharged from chemotherapy treatment.
In the case, the beneficiary, who had breast cancer, filed a lawsuit to force her health insurance company to pay for an egg cryopreservation procedure. The treatment was necessary to preserve her reproductive capacity, which would be ensured by freezing her eggs.
The plan operator mainly claimed that the contract expressly excluded in vitro fertilization techniques, artificial insemination and any other assisted reproduction methods.
However, according to the STJ, infertility treatment is different from taking measures to preserve fertility due to the probable adverse effect of chemotherapy.
And since chemotherapy is provided by the health insurance plan, coverage should be extended to its effects, since they are foreseeable and avoidable.
Therefore, the avoidable and foreseeable damage (infertility) resulting from the prescribed medical treatment (chemotherapy), when possible, must be prevented by the plan operator, who is bound by the obligation to provide medical assistance.
[1] Special Appeal No. 1962984
Authoria: Débora Carvalho do Santos.
