In the Brazilian system, court precedents have a pivotal role, contributing to the maintenance of legal certainty, and consistency in the decisions of Courts, as provided for in the rules of Articles 926 and 927 of the Code of Civil Procedure (CPC).
However, it is not difficult to notice a mismatch between theory and the reality of practice.
In a recent decision, the Court of Appeals of the State of Mato Grosso do Sul (TJMS) ruled in line with the caselaw established by the Superior Court of Justice (STJ) in a case revolving around group life insurance and occupational diseases.
The case stemmed from a collection suit filed by an insured who sought to equate occupational disease with occupational accident for the purpose of receiving insurance compensation.
At first, the TJMS ruled for the insured, based on the interpretation that the labor activity could be considered as a concomitant cause for disease worsening, which, according to that position, would justify the equivalence to the concept of personal accident.
However, STJ granted the insurer’s special appeal and ordered the return of the record to the Court of origin, so that it could review the express exclusion of occupational diseases from the concept of personal accident in the insurance agreement.
STJ pointed out that, according to its cemented caselaw, occupational diseases cannot be equated with occupational accidents for the purposes of insurance coverage when there are contractual clauses that clearly exclude this possibility.
Thus, TJMS revisited the case and accepted the motion for clarification filed by the insurer, recognizing the previous omission and aligning its understanding with the STJ’s position, stressing the restrictive interpretation of contractual clauses in group life insurance agreements, which should be strictly fulfilled.
This judgment reassures the strength of the STJ’s caselaw, and represents a significant advance in the establishment of the Superior Court’s understanding, which strengthens the Insurance Law by asserting insurance agreements guarantee the insured’s legitimate interest against predetermined risks.
In short, by aligning itself with the STJ’s position, TJMS conveys the Judiciary’s commitment to the technical and consistent application of Insurance Law, bolstering the confidence in contractual relations, and ensuring that insurance agreements are interpreted in keeping with the agreed terms, without unnecessarily going beyond these terms.
The insurer was represented by lawyers Gaya Schneider and Sérgio Bernardelli, members of the law firm Ernesto Borges Advogados.
Available in: https://www.migalhas.com.br/quentes/414618/tj-ms-reforma-decisao-e-exclui-doenca-ocupacional-de-acidente-pessoal
Autor: Gaya Lehn Schneider Paulino • email: gaya@ernestoborges.com.br • Tel.: +55 67 3389 0123
