projets
ATA/14/1995 ΓÇó Accident insurance: remand for expert assessment
ATA/14/1995Cour de justice / Chambre administrative13 janv. 1995Partially Granted
In an accident insurance case, the court found that the insurer's investigation was insufficient. Distinguishing a prior decision in which remand to the CNA for an expert report was refused, the court held that the present file justified a remand and ordered the insurer to obtain an expert assessment at its own expense.
Art. 6 LAA; when the accident insurer's fact-finding is insufficient, the case may be remanded for further investigation, including an expert assessment at the insurer's expense. Remand is not justified where the evidentiary basis is already sufficient and no investigatory deficiency can be reproached. The decisive criterion is the adequacy of the administrative instruction of the case; only a proven gap in the medical or factual record warrants referral back for supplementary evidence.
Descripteurs
ASSURANCE SOCIALE; ACCIDENT; AA; EXPERTISE; DECISION DE RENVOI
Normes
LAA.6
Résumé
Instruction du cas insuffisante de la part de l'assurance-accident. Dans une autre affaire, le TFA a refusé d'admettre le renvoi à la CNA pour ordonner une expertise dans un cas où on ne pouvait lui reprocher une instruction insuffisante (SJ 1993 p.559). Cas différent en l'espèce. Affaire renvoyée à l'assureur pour qu'il effectue une expertise à ses frais.