Coverage denials
Has your health insurance plan refused a test, therapy or procedure prescribed by your doctor?
A coverage denial can interrupt a diagnosis or compromise the continuity of treatment. That is why it is important to understand the reasons given by the insurer and to verify whether the refusal complies with the law, the contract and the rules of the National Supplementary Health Agency (ANS), the Brazilian regulator of private health insurance.
Our team works on the analysis of coverage denials and on guidance regarding the legally appropriate measures.
Have you received a denial from your health insurance plan? Send us the details of your case for legal analysis.
Most common cases
High-cost and off-label medications
Denials of high-cost or off-label medications, reviewed in light of the medical prescription.
Understand this caseSurgery denials
Surgeries denied or with delayed authorization, even with a medical indication.
Understand this caseSupply of surgical materials (OPME)
Orthoses, prostheses and special materials denied, disallowed or replaced by the insurer.
Understand this caseTherapies for ASD
Therapies denied, limited or with reduced hours for people with ASD.
Understand this caseHome care
Home care denied, reduced or discontinued by the insurer.
Understand this caseBariatric surgery
Bariatric surgery coverage denied or delayed, even with a medical indication.
Understand this caseChemotherapy
Cancer treatment denied or awaiting authorization from the insurer.
Understand this caseArtificial insemination
Coverage of assisted reproduction and of associated tests and treatments.
Understand this caseReview of monthly fees and premiums (false collective plans)
Steep premium increases in affiliation-based or small employer group plans with few beneficiaries.
Understand this caseSend us the details of your case, with no obligation
Fill in the fields below and our team will get back to you. If you prefer, reach out directly on WhatsApp.
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Brasília Office (Águas Claras)
QS 1 Rua 212, Lotes 19, 21 e 23, Edifício Condomínio Connect Towers, sala 1119 – Brasília/DF, 71950-550
- moreira.lf@uol.com.br
- Business hours
- Monday to Friday, 8am to 6pm