JURISPRUDENTIAL ANALYSIS OF HEALTH PLAN COVERAGE FOR ASD TREATMENT AND PROTECTION OF HUMAN DIGNITY IN THE FACE OF TREATMENT DENIALS

Abstract

This article analyzes the role of the Judiciary in response to health insurance providers’ refusals to cover multidisciplinary treatments for individuals with Autism Spectrum Disorder (ASD), with a focus on the protection of human dignity. The main objective of the research is to understand how Brazilian case law has ensured access to treatments indicated for ASD, considering the conflict between health insurance contractual clauses and the fundamental rights established in the Federal Constitution. Using a qualitative approach and deductive method, the study is based on the analysis of decisions from the Superior Court of Justice, such as AgInt in AREsp No. 2.479.197/SP, as well as regulations from the National Supplementary Health Agency (ANS), such as Resolution No. 539/2022. The study concludes that unjustified denials of coverage constitute violations of consumer protection laws, Law No. 12.764/2012, and the principle of human dignity, impacting not only the well-being of individuals with ASD but also their social inclusion. The article reaffirms the importance of judicial intervention as a means to enforce the rights of people with disabilities and advocates for a humanized and inclusive interpretation of the supplementary health system regulations.