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ATA/133/1995 ΓÇó Territoriality principle bars daily allowance abroad
ATA/133/1995Cour de justice / Chambre administrative14 mars 1995Dismissed
An insured person became ill while on holiday in Spain and claimed daily allowances. The benefit was refused, and the refusal was upheld on the basis that the territoriality principle precluded payment abroad under Art. 12 LAMA.
LAMA art. 12; territoriality principle and daily allowances abroad: sickness occurring while the insured is staying abroad does not, absent a statutory exception, give rise to entitlement to daily allowances. The place of stay may be decisive for coverage where the scheme is territorially limited; holidays abroad do not in themselves suspend the territorial requirement. Refusal of benefits is therefore upheld when the claim falls outside the territorial scope of the insurance coverage.
Descripteurs
ASSURANCE SOCIALE; AM; PRINCIPE DE LA TERRITORIALITE; INDEMNITE JOURNALIERE
Normes
LAMA.12
Résumé
Assuré tombé malade en vacances en Espagne. Indemnités journalières refusées en vertu du principe de la territorialité.