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Healthcare litigation in Brazil: technical defense at the speed of urgency
Coverage injunctions, claim denial collections, malpractice suits. Every case requires clinical evidence, regulatory reasoning and a fast response.
Healthcare litigation in Brazil covers court and arbitration proceedings in the sector: coverage lawsuits with requests for injunctions, disputes between operators and providers, collection of denied claims, civil liability of hospitals and clinics and contract review. Seek a lawyer as soon as you receive a summons, an injunction notice or an extrajudicial notice, because deadlines are short.
Healthcare litigation in Brazil brings together cases in which time weighs as much as the merits. Health plan operators, hospitals, clinics, laboratories and cooperatives face lawsuits from beneficiaries, disputes among themselves and damages claims, almost always with complex technical evidence.
The landscape has changed in recent years. Law No. 14,454/2022 amended Law No. 9,656/1998 (the Health Plans Law) and set criteria for coverage outside the ANS list of procedures (the rol, the mandatory coverage list). On September 18, 2025, ruling on ADI 7,265 (a direct action of unconstitutionality), the STF (Brazil's Supreme Federal Court) upheld the law and defined cumulative requirements for that coverage, such as a prescription by a qualified professional, no alternative on the list, scientific evidence and ANVISA registration. These parameters guide both the defense and the claim in each case.
Our approach starts with evidence. We build the defense on medical records, expert opinions, contract terms and regulatory rules, and choose the procedural strategy according to risk: settlement, a full defense or an appeal to the higher courts.
When to call a lawyer
Coverage injunction granted
The order requires authorization of treatment, medication or hospitalization within a short deadline, under a daily fine, and must be complied with or challenged immediately.
Summons in a damages lawsuit
A patient or relative alleges a failure in care and seeks compensation from a hospital, clinic or professional.
Claim denials with no administrative solution
The claim denial appeal is exhausted, the amounts are significant and the provider must decide whether to sue.
Dispute over termination or price adjustment
Operator and provider disagree on contract termination, adjustments or pending payments, and negotiation has stalled.
What happens when you leave it for later
- A daily fine for non-compliance with an injunction, which grows while the company decides what to do.
- Default or a defense without technical evidence, leading to a judgment that could have been avoided or reduced.
- The limitation period running out on denied claims that were not collected in time.
- Unfavorable precedents that repeat in other cases against the same company.
How we work
Triage and immediate response
We assess the order or summons, define what to comply with, what to challenge and by when, and guide the operational team.
Building the evidence
We gather medical records, authorizations, contracts and expert opinions, and appoint technical assistants for court-ordered expert examinations.
Procedural strategy
We define arguments, requests and available appeals, and assess the feasibility of settlement whenever it serves the client's interest.
Case management
We attend hearings, expert examinations and oral arguments, at first instance and in the appellate courts, with periodic reports to the client.
Portfolio management
For companies with a high volume of lawsuits, we organize indicators, standardized arguments and risk alerts by type of claim.
What you receive
- Initial risk opinion with strategy and next steps
- Defenses, appeals and filings with technical and regulatory grounds
- Questions for experts and follow-up of medical expert examinations
- Periodic reports on the progress of each case
- Portfolio dashboard with recurring arguments and prevention points
Why the firm
Litigation connected to regulation
We use ANS and ANVISA rules as evidence, not just as citations.
Clinical evidence well translated
We turn medical records and technical literature into arguments that judges and experts can follow.
Prevention drawn from each case
Every lawsuit becomes a lesson for contracts, protocols and care, which helps reduce new claims.
Illustrative scenario
Hypothetical scenario, for illustration only. A health plan operator is served with an injunction ordering coverage of a therapy not on the ANS list, under a daily fine. On the same day, the legal team checks the prescription, the product's ANVISA registration, whether an alternative exists on the list and the scientific evidence submitted, in light of the criteria set by the STF in ADI 7,265. With these elements, the operator decides between complying while filing a technical response or appealing on specific grounds. In parallel, the regulatory team reviews the internal workflow for analyzing such requests. The outcome depends on the court and the evidence in each case.
A hypothetical scenario, shown only to illustrate our method. Every case depends on its own facts.Frequently asked questions
What is healthcare litigation in Brazil?
It is work on court and arbitration proceedings involving health plan operators, providers, patients and suppliers in the healthcare sector. It includes coverage lawsuits, collection of denied claims, contract disputes and civil liability. The defense requires command of regulation and clinical evidence.
What did the STF decide on coverage outside the ANS list?
In 2025, ruling on ADI 7,265, the STF upheld Law No. 14,454/2022 and set cumulative requirements for coverage outside the list. They include a prescription by a qualified professional, no therapeutic alternative on the list, scientific evidence of efficacy and safety and ANVISA registration. The analysis is always case by case.
How should a health plan respond to an injunction?
First, comply with the order or obtain a stay within the deadline set, to avoid fines. In parallel, the defense assesses whether the case meets the legal requirements and prepares an appeal or technical response. Complying with the injunction does not prevent discussion of the merits.
Is a hospital liable for errors by a physician on its medical staff?
It may be, depending on the physician's relationship with the hospital and the nature of the failure. Case law distinguishes failures of hospital services, such as facilities and nursing, from purely medical acts. Clear contracts and complete medical records are the basis of the defense.
Can denied claims be collected in court?
Yes, when the administrative appeal does not resolve the issue or when the contract allows direct collection. The claim depends on proof of care, authorization and correct billing. The limitation period must be checked case by case, before the credit is lost.
Is it worth settling a healthcare case?
Sometimes, yes. Settlement makes sense when the risk of an adverse judgment, the cost of the case and the impact on the relationship with the patient or partner outweigh the gain from litigating. The assessment is technical and case by case, without giving up arguments that matter for the portfolio.
Related matters
Received an injunction, summons or notice?
Send us the document now. We assess the deadline, the risk and the first step of the defense.