Objection required before appeal to the social insurance court

ATA/222/1996Tribunal de Justiça / Câmara Administrativa23 de abr. de 1996Dismissed

Extraído pela Omnilex

Resumo Omnilex

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.

Sumário Omnilex

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.

Texto completo

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.

Palavras-chave

social insurancehealth insuranceobjection procedureadmissibilityappeal

Extraído pela Omnilex

Questões jurídicas principais extraídas pela Omnilex

Questão jurídica principal

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

Decisão extraída

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

Fundamentação extraída

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 courtGerado por IA