Legislator Jurisprudence & Législation
DE FR IT EN
Analyser dans Legislator
ECLI:BE:CTBRL:2017:ARR.20170914.5 ECLI:BE:CTBRL:2017:ARR.20170914.5 Généré par l'IA

Court holds that a prosthesis is 'made to measure' if specific dimensions or materials are required due to the insured's condition.

Numéro de cause ECLI:BE:CTBRL:2017:ARR.20170914.5
Autorité / Tribunal
Juridiction Belgique (BE)
Date de la décision
Issue du litige Admis (Allowed)
Ouvrir la source officielle Version Markdown lisible par machine (.md)

Synthèse Legislator

Généré par l'IA

The court ruled that a prosthesis qualifies as 'made to measure' under the 2014 Royal Decree if it is manufactured to specific dimensions or requires alternative materials due to the insured's specific medical condition. The insured argued that standard prostheses did not meet their needs, while the opposing party contended that only custom-fitted prostheses fit the legal definition. The court decided that the requirement for specific dimensions or material substitution due to the insured's pathology satisfies the 'made to measure' criteria.

Regeste Legislator

Généré par l'IA

Royal Decree of 25 June 2014; A prosthesis is considered 'made to measure' not only when tailored to specific dimensions but also when specific components must be made of different materials due to the insured's specific medical condition.

Mots-clés

Généré par l'IA
prosthesis made to measure medical equipment reimbursement specific medical condition material substitution requirement Royal Decree 2014 health insurance coverage custom medical device inexigible malgré l'atteinte corporelle

Dispositions légales citées

Généré par l'IA
Royal Decree of 25 June 2014
Law of 14 July 1994
Généré par l'IA
ECLI:BE:CASS:2026:CONC.20260226.1N.5
Military pensioner entitled to full prosthetic costs for recognized partial disability even if total disability percentage remains unchanged.
ECLI:BE:RVSCE:2017:ARR.237.952
Court dismisses appeal due to plaintiff's failure to request hearing, establishing deemed withdrawal of proceedings.
ECLI:BE:RVSCE:2025:ARR.264.447
Belgian Council of State annails Medex decision for failure to motivate severe illness recognition refusal.
ECLI:BE:RVSCE:2017:ARR.240.182
Belgian State court dismisses hospital appeal regarding mandatory network formation for medical implant reimbursement.
ECLI:BE:RVSCE:2017:ARR.239.245
Court dismisses appeal allowing extrapolation evidence when supported by other consistent proof under Belgian law.

Vous souhaitez savoir comment cet arrêt s'applique à votre dossier ?

Analysez cette décision avec la législation fédérale, le droit cantonal, la doctrine et la jurisprudence subséquente dans Legislator AI.

Ouvrir dans Legislator →

Texte complet

Fiche

Een prothese (implantaat) is niet enkel 'op maat' in de zin

van de bepalingen van het koninklijk besluit van 25 juni 2014 indien zij

volgens specifieke afmetingen gemaakt is. Een prothese kan ook beschouwd

worden als 'op maat' gemaakt, wanneer wegens de specifieke aandoening

van de verzekerde, een onderdeel van de prothese in een ander materiaal

dient gemaakt te worden dan de standaardprothese.

UTU-thesaurus:

SOCIAAL RECHT - SOCIALE ZEKERHEID - Ziektewetgeving - Verzekering geneeskundige verzorging

SOCIAAL RECHT - SOCIALE ZEKERHEID - Ziektewetgeving - Verzekering geneeskundige verzorging - Geneeskundige verstrekkingen

Wettelijke bepalingen:

Wet - 14-07-1994

Koninklijk Besluit - 25-06-2014