projetos

No individual insurance relationship without affiliation application

ATA/618/1995Tribunal de Justiça / Câmara Administrativa7 de nov. de 1995Dismissed

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Extraído pela Omnilex

Resumo Omnilex

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.

Sumário Omnilex

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.

Texto completo

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.

Palavras-chave

social insuranceaffiliationcollective insuranceindividual insurancejurisdictioninsurance relationship

Extraído pela Omnilex

Questões jurídicas principais extraídas pela Omnilex

Questão jurídica principal

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

Decisão extraída

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

Fundamentação extraída

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.

Questão jurídica principal

Whether the TA had jurisdiction to hear the dispute.

Decisão extraída

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

Fundamentação extraída

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

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