Brazil's STJ rules insurance must cover emergency care for pre-existing injuries

The Third Panel of the Superior Court of Justice (STJ) has unanimously ruled that travel insurance must cover emergency medical care abroad, even if the injury occurred before the trip began. The decision involves a case where Jacome Barbosa da Cruz sought emergency surgery in Mexico following a knee injury sustained from a fall in September 2021.

While the insurer, Chubb Seguros Brasil, argued that coverage should only apply to acute illnesses or accidents originating during the trip, the STJ found that the policy explicitly included coverage for crises related to pre-existing conditions. Minister Nancy Andrighi, the rapporteur, noted that the worsening of a condition does not constitute an intentional increase in risk unless there is evidence of fraud or bad faith, neither of which was proven in this case.

The case has been returned to the Court of Justice of Rio Grande do Sul (TJRS) to re-examine the appeal and determine the final compensation amount. A lower court had previously set the indemnity at R$ 8,950.15.