C-313/82

WyrokTSUE1984-03-15CELEX: 61982CJ0313ECLI:EU:C:1984:107

Analiza orzeczenia

Sekcja wygenerowana przez AI na podstawie treści orzeczenia — nie stanowi cytatu.

Zagadnienie prawne
Czy prywatna firma ubezpieczeniowa, która wypłaciła świadczenia z tytułu ubezpieczenia zdrowotnego o charakterze umownym, może być uznana za „instytucję” w rozumieniu art. 93 rozporządzenia (EWG) nr 1408/71, uprawnioną do regresu wobec osoby trzeciej odpowiedzialnej za szkodę?
Ratio decidendi
Trybunał stwierdził, że pojęcie „instytucji” w art. 93 rozporządzenia nr 1408/71, w świetle art. 1 lit. n) i art. 4 ust. 1 tego rozporządzenia, odnosi się do organu odpowiedzialnego za administrowanie ustawodawstwem państwa członkowskiego w zakresie zabezpieczenia społecznego. Art. 1 lit. j) rozporządzenia wyraźnie wyklucza „układy zbiorowe pracy” (industrial agreements) z definicji „ustawodawstwa”. Ponieważ stosunek między holenderską firmą ubezpieczeniową a ubezpieczoną był czysto umowny, a nie oparty na ustawodawstwie dotyczącym obowiązkowego ubezpieczenia społecznego, rozporządzenie nr 1408/71 nie miało zastosowania. W związku z tym firma ubezpieczeniowa nie mogła być uznana za „instytucję” w rozumieniu tego rozporządzenia.
Stan faktyczny
Holenderska obywatelka, pani Kenis, mieszkająca w Holandii, została ranna w wypadku drogowym w Belgii spowodowanym przez nieznaną osobę trzecią. Holenderska firma ubezpieczeniowa NV Tiel-Utrecht Schadeverzekering, która wypłaciła pani Kenis 94 069 BFR tytułem zwrotu kosztów leczenia na podstawie polisy ubezpieczenia zdrowotnego, wystąpiła w Belgii o zwrot tej kwoty od Gemeenschappelijk Motorwaarborgfonds (belgijskiego Funduszu Gwarancyjnego). Fundusz, który zgodnie z prawem belgijskim odpowiada za wypłatę odszkodowań za szkody spowodowane przez niezidentyfikowane, skradzione lub nieubezpieczone pojazdy, odmówił, twierdząc, że prawo belgijskie przyznaje prawo regresu tylko belgijskim instytucjom ubezpieczeniowym. Tiel-Utrecht argumentowała, że powinna być traktowana jako „instytucja” w rozumieniu art. 93 rozporządzenia 1408/71.
Rozstrzygnięcie
Pojęcie „instytucji” w art. 93 rozporządzenia (EWG) nr 1408/71 oznacza, w odniesieniu do każdego państwa członkowskiego, organ lub władzę odpowiedzialną za administrowanie całością lub częścią ustawodawstwa państwa członkowskiego dotyczącego gałęzi lub systemów zabezpieczenia społecznego wymienionych w tym rozporządzeniu.

Pełny tekst orzeczenia

Avis juridique important | 61982J0313 Judgment of the Court (First Chamber) of 15 March 1984. - NV Tiel-Utrecht Schadeverzekering v Gemeenschappelijk Motorwaarborgfonds. - Reference for a preliminary ruling: Rechtbank van eerste aanleg Hasselt - Belgium. - Road accident - Medical expenses - Recovery by the insurance institution. - Case 313/82. European Court reports 1984 Page 01389 Summary Parties Subject of the case Grounds Decision on costs Operative part Keywords . SOCIAL SECURITY FOR MIGRANT WORKERS - RIGHTS OF INSTITUTIONS RESPONSIBLE FOR BENEFITS AGAINST LIABLE THIRD PARTIES - INSTITUTION - MEANING ( REGULATION NO 1408/71 OF THE COUNCIL , ART . 1 ( N ) AND ART . 93 ) 2 . SOCIAL SECURITY FOR MIGRANT WORKERS - COMMUNITY REGULATIONS - MATTERS COVERED - ' ' INDUSTRIAL AGREEMENTS ' ' - EXCLUSION ( REGULATION NO 1408/71 OF THE COUNCIL , ART . 1 ( J )) Summary . THE TERM ' ' INSTITUTION ' ' IN ARTICLE 93 OF REGULATION NO 1408/71 MEANS , IN RESPECT OF EACH MEMBER STATE , THE BODY OR AUTHORITY RESPONSIBLE FOR ADMINISTERING ALL OR PART OF THE MEMBER STATE ' S LEGISLATION RELATING TO THE BRANCHES OR SCHEMES OF SOCIAL SECURITY MENTIONED IN THAT REGULATION . . REGULATION NO 1408/71 DOES NOT APPLY TO ' ' INDUSTRIAL AGREEMENTS ' ' ( DISPOSITIONS CONVENTIONNELLES ). THEREFORE THE RELATIONSHIP EXISTING BETWEEN AN INSURED PERSON AND AN INSURANCE COMPANY UNDER INSURANCE HAVING A PURELY CONTRACTUAL BASIS DOES NOT , BY REASON OF ITS NATURE , FALL WITHIN THE SCOPE OF REGULATION NO 1408/71 . Parties IN CASE 313/82 REFERENCE TO THE COURT UNDER ARTICLE 177 OF THE EEC TREATY BY THE BURGERLIJKE RECHTBANK VAN EERSTE AANLEG ( CIVIL COURT OF FIRST INSTANCE ), HASSELT , FOR A PRELIMINARY RULING IN THE ACTION PENDING BEFORE THAT COURT BETWEEN NV TIEL-UTRECHT SCHADEVERZEKERING , HAVING ITS REGISTERED OFFICE AT UTRECHT , AND GEMEENSCHAPPELIJK MOTORWAARBORGFONDS ( JOINT MOTOR GUARANTEE FUND ), HAVING ITS HEADQUARTERS AT BRUSSELS , Subject of the case ON THE INTERPRETATION OF ARTICLE 93 OF REGULATION ( EEC ) NO 1408/71 OF 14 JUNE 1971 ON THE APPLICATION OF SOCIAL SECURITY SCHEMES TO EMPLOYED PERSONS AND THEIR FAMILIES MOVING WITHIN THE COMMUNITY ( OFFICIAL JOURNAL , ENGLISH SPECIAL EDITION 1971 ( II ) P . 416 ), Grounds BY A JUDGMENT OF 25 NOVEMBER 1982 , WHICH WAS RECEIVED AT THE COURT ON 10 DECEMBER 1982 , THE BURGERLIJKE RECHTBANK VAN EERSTE AANLEG ( CIVIL COURT OF FIRST INSTANCE ), HASSELT , BELGIUM , REFERRED TO THE COURT FOR A PRELIMINARY RULING UNDER ARTICLE 177 OF THE EEC TREATY TWO QUESTIONS ON THE INTERPRETATION OF ARTICLE 93 OF REGULATION ( EEC ) NO 1408/71 OF THE COUNCIL OF 14 JUNE 1971 ON THE APPLICATION OF SOCIAL SECURITY SCHEMES TO EMPLOYED PERSONS AND THEIR FAMILIES MOVING WITHIN THE COMMUNITY ( OFFICIAL JOURNAL , ENGLISH SPECIAL EDITION 1971 ( II ), P . 416 ). THOSE QUESTIONS WERE RAISED IN A DISPUTE BETWEEN A NETHERLANDS INSURANCE COMPANY , NV TIEL-UTRECHT SCHADEVERZEKERING , AND THE BELGIAN GEMEENSCHAPPELIJK MOTORWAARBORGFONDS ( JOINT MOTOR GUARANTEE FUND , HEREINAFTER REFERRED TO AS ' ' THE FUND ' ' ) FOLLOWING A ROAD ACCIDENT IN BELGIUM IN WHICH MRS KENIS , A NETHERLANDS NATIONAL LIVING IN THE NETHERLANDS , WAS INJURED . AS A RESULT OF LEGAL PROCEEDINGS IT WAS ESTABLISHED THAT THE ACCIDENT IN QUESTION HAD BEEN CAUSED BY AN UNKNOWN THIRD PARTY . TIEL-UTRECHT , WHICH HAD PAID MRS KENIS BFR 94 069 AS REIMBURSEMENT OF MEDICAL EXPENSES UNDER A HEALTH-CARE INSURANCE POLICY HELD BY HER , BROUGHT AN ACTION IN BELGIUM FOR THE RECOVERY OF THAT AMOUNT AGAINST THE FUND , WHICH UNDER BELGIAN LAW IS RESPONSIBLE FOR PAYING COMPENSATION FOR INJURIES AND DAMAGES CAUSED BY UNIDENTIFIED , STOLEN OR UNINSURED MOTOR VEHICLES . THE FUND ARGUED BEFORE THE BELGIAN COURT THAT IT WAS NOT LIABLE TO REIMBURSE THE SUM PAID TO MRS KENIS BY TIEL-UTRECHT BECAUSE THE BELGIAN LAW OF 9 AUGUST 1963 INTRODUCING A COMPULSORY SICKNESS AND INVALIDITY INSURANCE SCHEME , IN PARTICULAR ARTICLE 70 THEREOF , INTENDED THAT ONLY THE BELGIAN INSTITUTIONS RESPONSIBLE FOR APPLYING THE PROVISIONS ON COMPULSORY INSURANCE WERE TO HAVE A RIGHT OF RECOVERY AGAINST THE FUND . TIEL-UTRECHT , RELYING ON ARTICLE 93 OF REGULATION NO 1408/71 , SUBMITTED THAT IT SHOULD BE CONSIDERED AN ' ' INSTITUTION ' ' WITHIN THE MEANING OF THAT REGULATION AND THEREFORE TREATED IN THE SAME WAY AS BELGIAN INSURANCE INSTITUTIONS . THE FUND SUBMITTED THAT REGULATION NO 1408/71 WAS INAPPLICABLE IN THIS CASE , ON THE GROUND THAT THE RELATIONSHIP BETWEEN TIEL-UTRECHT AND THE INSURED PERSON WAS OF A CONTRACTUAL NATURE , AND ARGUED THAT THE BELGIAN LEGISLATION COULD NOT BE APPLIED ' ' BY ANALOGY ' ' TO A LEGAL ENTITY INCORPORATED UNDER NETHERLANDS LAW . IN THOSE CIRCUMSTANCES THE BURGERLIJKE RECHTBANK VAN EERSTE AANLEG , HASSELT , REFERRED THE FOLLOWING QUESTIONS TO THE COURT FOR A PRELIMINARY RULING : ' ' 1 . WHETHER OR NOT THEY ARE REGARDED AS ' NATIONAL FEDERATIONS ' ( LANDSBONDEN ) OR ' RELIEF FUNDS ' ( HULPKAS ) WITHIN THE MEANING OF ARTICLE 2 ( D ) OF THE BELGIAN LAW OF 9 AUGUST 1963 , MUST THE ' INSTITUTIONS ' REFERRED TO IN ARTICLE 93 ( OF REGULATION NO 1408/71 ) BE UNDERSTOOD AS BEING ' INSURANCE INSTITUTIONS ' WITHIN THE MEANING OF THE LAST PARAGRAPH OF ARTICLE 70 OF THE BELGIAN LAW OF 9 AUGUST 1963? 2.MUST THE EXPRESSIONS ' LIABLE THIRD PARTIES ' AND ' THIRD PARTY BOUND TO COMPENSATE FOR THE INJURY ' APPEARING IN ARTICLE 93 OF THE REGULATION BE TAKEN TO MEAN THE SAME AS THE TERMS ' VERGOEDINGSPLICHTIGEN ' ( PERSONS LIABLE TO MAKE GOOD THE DAMAGE ) AND ' AANSPRAKELIJKEN ' ( PERSONS LIABLE ) APPEARING IN ARTICLE 1382 ET SEQ . OF THE BELGIAN CIVIL CODE? OR MUST THEY INSTEAD BE CONSTRUED MORE WIDELY AS COVERING ANY OR EVERY OTHER POSSIBLE RIGHT OF RECOVERY? ' ' 8 IT MUST BE POINTED OUT THAT ARTICLE 15 OF THE BELGIAN LAW OF 1 JULY 1956 ON COMPULSORY INSURANCE AGAINST LIABILITY TO THIRD PARTIES IN RESPECT OF MOTOR VEHICLES PROVIDES THAT ALL INSURERS MUST BE AFFILIATED TO A JOINT GUARANTEE FUND WHICH IS REQUIRED TO ASSUME THE OBLIGATIONS OF PERSONS CAUSING CERTAIN ACCIDENTS AND IN PARTICULAR TO PAY DAMAGES IN RESPECT OF PHYSICAL INJURIES CAUSED BY UNIDENTIFIED OR STOLEN MOTOR VEHICLES OR VEHICLES NOT COVERED BY INSURANCE IN ACCORDANCE WITH THE PROVISIONS OF THE LAW . IT WAS PRECISELY FOR THAT PURPOSE THAT THE FUND WAS CREATED IN THE FORM OF A MUTUAL INSURANCE ASSOCIATION AND WAS AUTHORIZED BY ROYAL DECREE OF 31 JANUARY 1957 . 9 THE BELGIAN LAW OF 9 AUGUST 1963 , INTRODUCING AND REGULATING A COMPULSORY SICKNESS AND INVALIDITY INSURANCE SCHEME , REGULATES IN ARTICLE 70 THE RELATIONSHIP BETWEEN THE INSTITUTIONS RESPONSIBLE FOR ADMINISTERING THE SICKNESS AND INVALIDITY INSURANCE SCHEME AND THE FUND AS FAR AS CONCERNS THE COSTS WHICH THE INSURANCE INSTITUTIONS INCUR AS A RESULT OF ROAD ACCIDENTS CAUSED BY UNIDENTIFIED , STOLEN OR UNINSURED VEHICLES . THAT LAW PROVIDES THAT IN SUCH CASES ' ' THE INSURANCE INSTITUTION SHALL HAVE A SPECIFIC RIGHT OF RECOVERY AGAINST THE GEMEENSCHAPPLIJK MOTORWAARBORGFONDS REFERRED TO IN ARTICLE 15 OF THE LAW OF 1 JULY 1956 ' ' . ARTICLE 2 ( D ) OF THE SAME LAW DEFINES ' ' INSURANCE INSTITUTIONS ' ' AS THE RELIEF FUND FOR SICKNESS AND INVALIDITY INSURANCE ( HULPKAS VOOR ZIEKTE-EN INVALIDITEITSVERZEKERING ) AND THE ' ' AUTHORIZED NATIONAL FEDERATIONS ' ' ( LANDSBONDEN ), THAT IS TO SAY BELGIAN INSTITUTIONS ONLY . AS REGARDS REGULATION NO 1408/71 , ARTICLE 93 , WHICH IS HEADED ' ' RIGHTS OF INSTITUTIONS RESPONSIBLE FOR BENEFITS AGAINST LIABLE THIRD PARTIES ' ' , PROVIDES THAT : ' ' IF A PERSON RECEIVES BENEFITS UNDER THE LEGISLATION OF ONE MEMBER STATE IN RESPECT OF AN INJURY RESULTING FROM AN OCCURRENCE IN THE TERRITORY OF ANOTHER STATE , ANY RIGHTS OF THE INSTITUTION RESPONSIBLE FOR BENEFITS AGAINST A THIRD PARTY BOUND TO COMPENSATE FOR THE INJURY SHALL BE GOVERNED BY THE FOLLOWING RULES : ( A ) WHERE THE INSTITUTION RESPONSIBLE FOR BENEFITS IS , BY VIRTUE OF THE LEGISLATION WHICH IT ADMINISTERS , SUBROGATED TO THE RIGHTS WHICH THE RECIPIENT HAS AGAINST THE THIRD PARTY , SUCH SUBROGATION SHALL BE RECOGNIZED BY EACH MEMBER STATE ; ( B)WHERE THE SAID INSTITUTION HAS DIRECT RIGHTS AGAINST THE THIRD PARTY , SUCH RIGHTS SHALL BE RECOGNIZED BY EACH MEMBER STATE . ' ' 11 IN THE COMMISSION ' S OPINION , REGULATION NO 1408/71 IS NOT APPLICABLE IN THE PRESENT CASE SINCE , AS REGARDS ITS APPLICABILITY RATIONE PERSONAE , IT DOES NOT APPEAR FROM THE INFORMATION AVAILABLE THAT MRS KENIS BELONGS TO THE CATEGORY OF WORKERS MOVING WITHIN THE COMMUNITY OR MEMBERS OF THEIR FAMILIES AND SINCE , AS REGARDS ITS APPLICABILITY RATIONE MATERIAE , THE RELATIONSHIP BETWEEN MRS KENIS AND TIEL-UTRECHT SEEMS TO BE BASED ON A CONTRACT GOVERNED BY PRIVATE LAW AND NOT ON THE APPLICATION OF LEGISLATION ON COMPULSORY SICKNESS AND INVALIDITY INSURANCE . THE FIRST QUESTION 12 IN SO FAR AS THE FIRST QUESTION SEEMS TO BE FORMULATED IN SUCH A WAY AS TO REQUIRE THE INTERPRETATION OF A PROVISION OF NATIONAL LAW - NAMELY , ARTICLE 70 OF THE BELGIAN LAW OF 9 AUGUST 1963 - , IT MUST BE POINTED OUT THAT THE COURT MAY SELECT FROM ALL THE INFORMATION PROVIDED BY THE NATIONAL COURT THOSE ELEMENTS OF COMMUNITY LAW WHICH , HAVING REGARD TO THE FACTS OF THE CASE , REQUIRE A RULING ON INTERPRETATION OR VALIDITY . ACCORDINGLY , AND IN VIEW OF THE FACT THAT IN THE GROUNDS OF ITS JUDGMENT REQUESTING A PRELIMINARY RULING THE NATIONAL COURT EXPRESSED DOUBTS ABOUT THE MEANING OF THE TERM ' ' INSTITUTION ' ' IN ARTICLE 93 ( 1 ) OF REGULATION NO 1408/71 , THE FIRST QUESTION MUST BE UNDERSTOOD AS SEEKING AN INTERPRETATION OF THAT TERM . ACCORDING TO ARTICLE 1 ( N ) OF REGULATION NO 1408/71 , THE TERM ' ' INSTITUTION ' ' MEANS , IN RESPECT OF EACH MEMBER STATE , ' ' THE BODY OR AUTHORITY RESPONSIBLE FOR ADMINISTERING ALL OR PART OF THE LEGISLATION ' ' . ARTICLE 4 ( 1 ) OF THE SAME REGULATION RESTRICTS THE TERM ' ' LEGISLATION ' ' BY STATING UNDER THE HEADING ' ' MATTERS COVERED ' ' THAT THE REGULATION IS TO APPLY TO ALL LEGISLATION CONCERNING THE BRANCHES OF SOCIAL SECURITY LISTED IN PARAGRAPHS ( 1 ) AND ( 2 ). IN THIS CONTEXT ' ' LEGISLATION ' ' IS DEFINED BY ARTICLE 1 ( J ), WHICH PROVIDES THAT ' ' ' LEGISLATION ' MEANS IN RESPECT OF EACH MEMBER STATE STATUTES , REGULATIONS AND OTHER PROVISIONS AND ALL OTHER IMPLEMENTING MEASURES , PRESENT OR FUTURE , RELATING TO THE BRANCHES AND SCHEMES OF SOCIAL SECURITY COVERED BY ARTICLE 4 ( 1 ) AND ( 2 ) ' ' , BUT EXCLUDES ' ' EXISTING OR FUTURE INDUSTRIAL AGREEMENTS ' ' . 15 THE ANSWER TO THE FIRST QUESTION MUST THEREFORE BE THAT THE TERM ' ' INSTITUTION ' ' IN ARTICLE 93 OF REGULATION NO 1408/71 MEANS , IN RESPECT OF EACH MEMBER STATE , THE BODY OR AUTHORITY RESPONSIBLE FOR ADMINISTERING ALL OR PART OF THE MEMBER STATE ' S LEGISLATION RELATING TO THE BRANCHES OR SCHEMES OF SOCIAL SECURITY MENTIONED IN THAT REGULATION . IT IS CLEAR FROM THE CONSIDERATIONS SET OUT ABOVE THAT REGULATION NO 1408/71 DOES NOT APPLY TO ' ' INDUSTRIAL AGREEMENTS ' ' . YET TIEL-UTRECHT HAS STATED , IN ANSWER TO A QUESTION PUT TO IT BY THE COURT , THAT THE BASIS OF THE INSURANCE UNDER WHICH IT MADE PAYMENTS TO MRS KENIS WAS PURELY CONTRACTUAL . IT MUST THEREFORE BE CONCLUDED THAT THE RELATIONSHIP BETWEEN MRS KENIS AND TIEL-UTRECHT DOES NOT , BY REASON OF ITS NATURE , FALL WITHIN THE SCOPE OF REGULATION NO 1408/71 . 17 IN THOSE CIRCUMSTANCES IT IS NOT NECESSARY TO ANSWER THE SECOND QUESTION RAISED BY THE NATIONAL COURT , SINCE IT REFERS TO A PARTICULAR PROVISION OF A REGULATION WHICH , AS A WHOLE , IS NOT APPLICABLE TO THE RELATIONSHIP CONSIDERED ABOVE . Decision on costs COSTS 18 THE COSTS INCURRED BY THE COMMISSION OF THE EUROPEAN COMMUNITIES , WHICH HAS SUBMITTED OBSERVATIONS TO THE COURT , ARE NOT RECOVERABLE . AS THESE PROCEEDINGS ARE , IN SO FAR AS THE PARTIES TO THE MAIN PROCEEDINGS ARE CONCERNED , IN THE NATURE OF A STEP IN THE ACTION PENDING BEFORE THE NATIONAL COURT , THE DECISION ON COSTS IS A MATTER FOR THAT COURT . Operative part ON THOSE GROUNDS , THE COURT ( FIRST CHAMBER ), IN ANSWER TO THE QUESTION SUBMITTED TO IT BY THE BURGERLIJKE RECHTBANK VAN EERSTE AANLEG , HASSELT , BY JUDGMENT OF 25 NOVEMBER 1982 , HEREBY RULES : THE TERM ' ' INSTITUTION ' ' IN ARTICLE 93 OF REGULATION ( EEC ) NO 1408/71 MEANS , IN RESPECT OF EACH MEMBER STATE , THE BODY OR AUTHORITY RESPONSIBLE FOR ADMINISTERING ALL OR PART OF THE MEMBER STATE ' S LEGISLATION RELATING TO THE BRANCHES OR SCHEMES OF SOCIAL SECURITY MENTIONED IN THAT REGULATION .

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