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No individual insurance relationship without affiliation application

ATA/618/1995Court of Justice / Administrative ChamberNov 7, 1995Dismissed

Open source

Extracted by Omnilex

Omnilex summary

The appellant sought recognition of an individual insurance relationship after the end of her employment and the related collective insurance. The court held that, because she had not filed the required application for individual affiliation with the fund, no insurance relationship existed between the parties. As a result, the TA was not competent to hear the dispute.

Omnilex headnote

LAMA art. 5 bis al. 4; passage from collective to individual insurance requires the prescribed declaration/application for affiliation. If the insured person does not complete the individual affiliation request after termination of the employment contract and therefore of the collective cover, no insurance relationship arises vis-à-vis the fund; absent such relationship, the court lacks jurisdiction to decide the merits.

Full text

Descripteurs

ASSURANCE SOCIALE; AM; AFFILIATION; ASSURANCE COLLECTIVE; ASSURANCE INDIVIDUELLE; PASSAGE DANS L'ASSURANCE INDIVIDUELLE; DECLARATION DE PASSAGE; ASSU

Normes

LAMA.5 bis al.4

Résumé

La recourante n'ayant pas rempli une demande d'affiliation individuelle à la caisse après la résiliation de son contrat de travail (et, partant, celle du contrat collectif d'assurance), aucun rapport d'assurance n'existe entre les parties et le TA n'est compétent.

Keywords

social insuranceaffiliationcollective insuranceindividual insurancejurisdictioninsurance relationship

Extracted by Omnilex

Key legal questions extracted by Omnilex

Key legal question

Whether an individual insurance relationship existed after the end of the collective contract despite no affiliation application.

Extracted holding

No individual insurance relationship existed between the parties because the appellant did not submit the required application for individual affiliation.

Extracted reasoning

Following the termination of employment, and thus of the collective insurance contract, individual coverage could arise only through the prescribed declaration/application for passage into individual insurance. That step was not taken.

Key legal question

Whether the TA had jurisdiction to hear the dispute.

Extracted holding

The TA lacked jurisdiction because there was no insurance relationship between the parties.

Extracted reasoning

Without an existing insurance relationship, the dispute did not fall within the court's competence.

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