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JURITEXT000006955278 Généré par l'IA

Insured Spouse's Professional Activity Determining Sickness Benefit Eligibility

Numéro de cause JURITEXT000006955278
Autorité / Tribunal
Juridiction France (FR)
Date de la décision
Issue du litige Rejeté (Dismissed)
Ouvrir la source officielle Version Markdown lisible par machine (.md)

Synthèse Legislator

Généré par l'IA

The appeal contested the refusal to reimburse an insured person for his wife's medical expenses incurred in late 1955, based on the assertion that the wife was not professionally active. The court rejected this claim, reasoning that since the insured, an employee, owned a bar managed by his wife who was permanently substituting for him as he could not personally direct the business, the wife was deemed to be engaged in professional activity, thus disqualifying her from receiving sickness insurance benefits as the spouse of an insured person under the applicable Social Security Code article.

Regeste Legislator

Généré par l'IA

ARTICLE 285 DU CODE DE LA SECURITE SOCIALE; Insured Spouse's Professional Activity Determining Sickness Benefit Eligibility: The court rejected this claim, reasoning that since the insured, an employee, owned a bar managed by his wife who was permanently substituting for him as he could not personally direct the business, the wife was deemed to be engaged in professional activity, thus disqualifying her from receiving sickness insurance benefits as the spouse of an insured person under the applicable Social Security Code article.

Mots-clés

Généré par l'IA
conjoint droit à la prestation d'assurance prestations de sécurité sociale frais médicaux entreprise assurée devoir d'assistance

Dispositions légales citées

Généré par l'IA
ARTICLE 285 DU CODE DE LA SECURITE SOCIALE
The court upheld the decision because the wife exercised a professional activity, which, under this article, precluded granting sickness benefits to the insured's spouse.
Généré par l'IA
69-12437
Civil Servant Spouse's Dependent Status and Social Security Benefits Denial
JURITEXT000006956780
Voluntary Insured Spouse Medical Expense Reimbursement Denial
JURITEXT000006975128
Insurance Fund Reimbursement for Spouse's Medical Benefits
09-16540
Widow's Professional Illness Claim Time Limit and Due Process in Social Security Appeal
99-10987
Social Security Benefits Termination Upheld Due to Undisclosed Professional Activity

Questions juridiques clés extraites par Legislator

Généré par l'IA
ARTICLE 285 DU CODE DE LA SECURITE SOCIALE

The court upheld the decision because the wife exercised a professional activity, which, under this article, precluded granting sickness benefits to the insured's spouse.

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Texte complet

SUR LE MOYEN UNIQUE : ATTENDU QUE LE POURVOI REPROCHE A LA DECISION ATTAQUEE D'AVOIR REFUSE A Y..., ASSURE SOCIAL, LE REMBOURSEMENT DES FRAIS EXPOSES PAR LUI, EN RAISON DE LA MALADIE DE SON EPOUSE, SURVENUE EN NOVEMBRE ET DECEMBRE 1955, ALORS QUE CETTE DERNIERE N'EXERCERAIT PAS UNE ACTIVITE PROFESSIONNELLE ;

MAIS ATTENDU QU'AYANT RELEVE QUE Y..., AIDE-MAGASINIER AUX ETABLISSEMENTS THOMSON, ETAIT PROPRIETAIRE D'UN DEBIT DE BOISSONS DONT IL AVAIT CONFIE LA GESTION A SA FEMME ET QUE CELLE-CI, REMPLACAIT D'UNE FACON PERMANENTE SON MARI, QUI NE POUVAIT ASSURER PERSONNELLEMENT LA DIRECTION DU FONDS, LA COMMISSION REGIONALE D'APPEL EN A JUSTEMENT DEDUIT QUE DAME X... EXERCAIT UNE ACTIVITE PROFESSIONNELLE QUI, EN APPLICATION DE L'ARTICLE 285 DU CODE DE LA SECURITE SOCIALE, NE PERMETTAIT PAS DE LUI ACCORDER LES PRESTATIONS DE L'ASSURANCE-MALADIE EN QUALITE DE CONJOINT D'UN ASSURE SOCIAL ;

D'OU IL SUIT QUE LA DECISION EST LEGALEMENT JUSTIFIEE ;

PAR CES MOTIFS : REJETTE LE POURVOI FORME CONTRE LA DECISION RENDUE LE 21 NOVEMBRE 1957 PAR LA COMMISSION REGIONALE D'APPEL DE PARIS ;

N° 58-50570 ;

Y... CHARLES C/ CAISSE PRIMAIRE CENTRALE DE SECURITE SOCIALE DE LA REGION PARISIENNE ;

PRESIDENT : M CAMBOULIVES, CONSEILLER DOYEN, FAISANT FONCTIONS ;

- RAPPORTEUR : M CONSTANT ;

- AVOCAT GENERAL : M LEMOINE ;

- AVOCAT : M HERSANT ;

A RAPPROCHER : 29 MAI 1958, BULL 1958, II, N° 360, P 240 ET L'ARRET CITE.