Background
Notre Dame Intermédica Saúde S.A. filed an internal appeal after the President of Brazil’s Superior Court of Justice declined to hear its appeal seeking review of the refusal to admit a special appeal. The President’s decision rested on the insurer’s failure to specifically challenge the grounds for inadmissibility.
The underlying dispute concerned the extent of health-plan coverage for home care, not whether home-care coverage was required at all. The decision barring the special appeal had applied STJ Precedent No. 83 because the lower-court ruling conformed to STJ case law concerning the application of Law No. 14,454/2022 to continuing health-insurance contracts.
The Court’s Holding
The Fourth Panel unanimously denied the internal appeal. It held that the insurer’s earlier appeal had not specifically and consistently addressed the application of Law No. 14,454/2022 to continuing contractual relationships, a ground supporting the refusal to admit the special appeal. The authorities cited by the insurer did not address that issue and were neither contemporaneous with nor later than the relevant legislative change and precedents.
Under Article 932(III) of the 2015 Code of Civil Procedure and Article 253, sole paragraph, I, of the STJ’s Internal Rules, an appeal may not be heard when it fails to challenge specifically every ground of the decision under review. Repeating arguments on the merits cannot cure that defect in a later internal appeal. The panel also ruled that STJ Topic 1,340 did not govern because that proceeding concerns contractual clauses excluding home care as an alternative to hospitalization, whereas this case concerned only the extent of coverage.
The panel declined the appellee’s request for an additional increase in appellate attorney fees. It applied the STJ Special Court’s rule that no further appellate-fee enhancement is imposed when an earlier decision that rejected or denied the party’s appeal has already increased fees under Article 85(11) of the Code of Civil Procedure.
Key Takeaways
- An appeal seeking admission of a special appeal must specifically address every ground for the challenged inadmissibility decision, whether or not those grounds are independent.
- Merely repeating the underlying merits arguments does not satisfy the requirement of appellate dialectics and cannot be repaired through a later internal appeal.
- STJ Topic 1,340 does not extend to disputes solely about the scope of home-care coverage when the existence of a right to such coverage is uncontested.
Why It Matters
The decision underscores that procedural precision is essential when seeking review by the STJ. A party must confront the actual legal and precedential basis for inadmissibility; otherwise, the court will not reach the merits even when the underlying dispute concerns significant health-insurance obligations.
For health-plan litigation, the ruling also distinguishes challenges to complete contractual exclusions of home care from disputes over how much home care must be provided. That distinction determines whether the controversy falls within the question framed in STJ Topic 1,340.