In a decision of significant economic dimensions, the director of the prepaid pharmaceutical company Bramed, in Cordoba, will pay $43,285,714.32 in compensation to an oncology patient who was left without coverage as a result of a fraudulent maneuver.
Instead, achieve this by requesting an employee Affiliation data is modified irregularly in the official system.
The action was approved by Judge Julian Falcucci of the Federal Oral Court 1 for that district, under Suspension of trial This is a test proposed by the businessman’s defense and accepted by both the victim and her husband, who expressed their willingness to reach this alternative solution.
More penalties for the manager
In addition to the amount of one million dollars, the judge accepted a proposal from the Public Prosecution, represented by Public Prosecutor Carlos Gonnilla, stipulating that the director – given his economic ability and the seriousness of the event – must pay the amount. Schedule and attend a gender perspective training session Intended for all company employees, replacing community tasks.
Probation was also given to the administrative employee who intervened in the matter Illegal maneuver Which consists of Fraudulently accessing a tax code For the patient to change social work
How was the maneuver done?
The case goes back to December 2020. That month, a Port Foremen and Stevedores Social Work woman – who received her benefits through Bramed – was diagnosed with Hodgkin’s lymphoma and was urgently taken to hospital. She was about to undergo heart surgery due to complications resulting from the tumor.
While she was going through this critical situation, one of the prepayment employees called her – at the manager’s request – to ask for her husband’s tax number, under the pretext of “correcting the data” and expediting the provision of the medicine. Since the patient was unable to speak after the intervention, she provided her husband’s contact number.
The husband received a message via WhatsApp and asked Pramid via email if this line belonged to the company. The accused employee later confirmed the number was correct, prompting the man to hand in his tax code on January 4, 2021.
With this information, and under the director’s instructions, Bramed employees entered the AFIP system and completed Dependent migration For social work for ministers, secretaries and deputy ministers, which is the body with which the company did not have an agreement.
he The change was registered with the Health Services Supervisory Authority without any approval. The maneuver was tracked: arrived from the prepaid offices in Cordoba.
There is no coverage in complete chemotherapy
The effect was devastating. When the member contacted the company in April 2021, they were informed that they no longer had Bramed coverage. They assured him in the offices that he himself had requested a social work transfer using his own tax code.
Between the change and its entry into force, the patient had begun her oncology treatment, but suffered repeated delays in drug delivery, lack of approval of practices and administrative hurdles, causing Serious damage to his health. According to the indictment, the consequences included emergency cardiac interventions, permanent tracheostomy, and A period in a coma, on the verge of losing life.
In a motion for referral to trial filed in October 2024, federal prosecutor Enrique Sinistrari stated that the maneuver — carried out “at the request” of the managing partner and “with the complicity” of the employee — placed the woman “in a state of helplessness, leaving her to her fate at an extremely dangerous moment,” with “irreparable” physical and psychological damage.
Judge Falcucci imposed a series of sanctions on the director and employee. Code of conduct for one year: Establish a headquarters, remain at the disposal of the Directorate for Surveillance and Assistance in the Enforcement of Criminal Law (DCAEP) and attend a gender perspective course that must also be implemented within Bramed, according to the Finance.gob.ar website of the Public Prosecutor’s Office.
the It was agreed to suspend the trial with the consent of the victim and her husband, who prioritized immediate compensation after four years of litigation.
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