Objection required before appeal to the social insurance court

ATA/222/1996Court of Justice / Administrative ChamberApr 23, 1996Dismissed

Extracted by Omnilex

Omnilex summary

The court held that, under LAMal art. 85, an insured person must first file an objection with the health insurer before bringing the matter before the social insurance court. Because this procedural step had not been taken, the appeal was dismissed as procedurally premature.

Omnilex headnote

LAMal art. 85; objection as a prerequisite to judicial appeal; before seizing the social insurance court, the insured must first exhaust the insurer’s objection procedure. A direct appeal filed without prior objection is inadmissible/dismissed for failure to satisfy the mandatory administrative precontentious step.

Full text

Descripteurs

ASSURANCE SOCIALE; OPPOSITION(PROCEDURE); ASSU

Normes

LAMAL.85

Résumé

Selon la LAMAL : Une opposition doit être faite à la caisse-maladie avant le dépôt d'un recours au TCA.

Keywords

social insurancehealth insuranceobjection procedureadmissibilityappeal

Extracted by Omnilex

Key legal questions extracted by Omnilex

Key legal question

Whether an objection to the health insurer is a prerequisite before filing an appeal with the social insurance court under LAMal.

Extracted holding

Yes. The insured must first lodge an objection with the health insurer before seizing the social insurance court.

Extracted reasoning

The cited rule requires the administrative objection procedure to be exhausted before judicial review can be sought.

Objection required before appeal to the social insurance courtAI generated