Entitlement to benefits begins upon receipt of affiliation application

ATA/320/1997Cour de justice / Chambre administrative27 mai 1997Other

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Résumé

The decision clarifies the temporal relationship between affiliation and benefit entitlement in social insurance. It holds that the right to benefits begins on the day an approved fund receives the request for affiliation. The court distinguishes this from the start of insurance coverage; the two moments coincide only where the statutory scheme does not provide for a probationary period or waiting time.

Regest

LAMO art. 19; affiliation to an approved fund and commencement of entitlement to benefits. The start of insurance coverage must be distinguished from the start of the right to benefits. Entitlement begins upon receipt of the affiliation application by the approved fund; the two dates coincide only where the statutory provisions do not establish a qualifying period or waiting time.

Texte intégral

Descripteurs

ASSURANCE SOCIALE; AM; AFFILIATION; COUVERTURE; PRESTATION D'ASSURANCE(EN GENERAL); REMBOURSEMENT DE FRAIS(ASSURANCE); ASSU

Normes

LAMO.19

Résumé

Le droit aux prestations court dès le jour où une caisse agréé reçoit une demande d'affiliation. Il faut distinguer le début de l'assurance du début du droit aux prestations. Ces deux moments ne coïncident que lorsque les dispositions statutaires ne prévoient pas de stage ou de délais d'attente.

Mots-clés

social insuranceinsurance coveragebenefit entitlementaffiliationwaiting periodreimbursement of expenses