832.01 LVLAMAL

CH-VD

Art. 12 LOI d'application vaudoise de la loi fédérale sur l'assurance-maladie (LVLAMal) - Situation économique réelle du requérant [ 1, 9, 10, 11 ]

Titre II, Chapitre I

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Art. 12 LVLAMal · Situation économique réelle du requérant [ 1, 9, 10, 11 ]

1. Lorsque le calcul fondé sur la situation économique réelle du requérant aboutit à un revenu déterminant qui diffère de 20% ou plus du revenu déterminant au sens de l'article 11, l'OVAM se fonde, pour des motifs d'équité, sur le revenu déterminant fondé sur la situation économique réelle du requérant. Pour l'établir, l'OVAM se base sur une déclaration du requérant sur sa situation économique réelle. A la demande de l'OVAM, l'agence d'assurances sociales vérifie et vise ladite déclaration.

1bis. Les déductions que l'OVAM peut opérer en vue d'établir le revenu déterminant basé sur la situation économique réelle du requérant sont définies dans le règlement.

1ter. L'OVAM peut se baser sur les dépenses réelles annoncées par le requérant dans la déclaration sur sa situation économique réelle dès lors qu'elles sont supérieures aux revenus.

1quater. Lorsque le requérant annonce des revenus ponctuels dans la déclaration sur sa situation économique réelle, l'OVAM procède à une annualisation des revenus.

2. Les apprentis et étudiants, dès le début de leur 19ème année, lorsque leurs parents n'ont pas droit au subside, bénéficient par analogie de la même procédure, qui prend en compte leur situation financière ainsi que celle de leurs parents (art. 277, al. 2 CC [G] ).

3. Les étrangers qui vivent seuls en Suisse, devant disposer des moyens financiers nécessaires au sens de la loi fédérale du 16 décembre 2005 sur les étrangers (LEtr), n'ont en principe pas droit au subside, sous réserve du cas de rigueur prévu à l'article 13.

4. …

← Art. 11 LVLAMal d'application vaudoise de la loi fédérale sur l'assurance-maladie (LVLAMal) - But Art. 13 LVLAMal →

Décisions judiciaires appliquant cette disposition (31)

Arr.t.2021.16 · vd (art. 12 LVLAMal)

Appeal Regarding 2017 Health Insurance Subsidy Denial Based on Annualized Unemployment Income

Used to determine the income based on the applicant's actual economic situation when it differs significantly from the standard calculation (Article 11).

Arr.t.2019.522 · vd (art. 12 al. 1 LVLAMal)

Appeal on Health Insurance Subsidy Reduction Based on Untimely Opposition and Income Calculation

The exception rule allowing calculation based on the applicant's actual economic situation if it differs by 20% or more from the income under Art. 11 LVLAMal, used to confirm the validity of using the Art. 11 income.

Arr.t.2019.197 · vd (art. 12 al. 1bis LVLAMal)

Insured vs. Health Insurer: Professional Expense Deductions for Subsidy Calculation

This article was the substantive basis for allowing the calculation based on the applicant's actual economic situation, which the court ultimately confirmed.

Arr.t.2019.199 · vd (Art. 12 al. 1 LVLAMal)

Insured Person v. Social Health Insurer: Subsidy Calculation Based on Provisional Income Data

The court rejected the appeal, confirming the decision that applied this article to calculate the determined income based on the applicant's actual economic situation.

Arr.t.2018.782 · vd (art. 12 LVLAMal)

Insured's Appeal of Reduced Health Subsidy Based on Outdated Income Calculation Denied

The final order confirms the decision based on the assessment made under this article, which concerns the calculation of the determinative income for subsidies, especially when deviating from the standard calculation.

Arr.t.2018.92 · vd (Art. 12 LVLAMal)

Insured Party v. Health Insurance Subsidy Calculation

The court examined the applicant's request to calculate the subsidy based on the actual financial situation under this provision.

Arr.t.2017.521 · vd (art. 12 LVLAMal)

Health Insurance Premium Subsidy Calculation Based on Current vs. Prior Year Income

The court noted that the subsidy calculation would have to be determined based on the real economic situation under this article, even if the taxation decision had been used.

Arr.t.2016.785 · vd (Art. 12 LVLAMal)

Petitioners v. Health Insurance Office: Premium Subsidy Eligibility Based on 2014 Income

Cited in the reasoning as the basis for the insurance office to rely on the real economic situation when there is a significant difference from the standard calculation.

Arr.t.2015.617 · vd (Art. 12 LVLAMal)

Insured Person v. Insurance Office Regarding Sickness Benefit Subsidy Recalculation

Cited in the introductory list of applicable provisions and governs when the actual economic situation must be used to determine the income for subsidies.

Arr.t.2014.694 · vd (art. 12 al. 1 LVLAMal)

Appeal Regarding Health Insurance Premium Subsidies Based on Change in Income Circumstances and Deductible Expenses

The court implicitly upheld the administrative authority's application of this article, which allows basing the subsidy calculation on the actual financial situation when it deviates by 20% or more from the fiscal determination (Art. 11 LVLAMal).

Arr.t.2014.171 · vd (Art. 12 al. 1 LVLAMal)

Mandatory Health Insurance Premium Subsidies: Actual Financial Situation vs. Fiscal Income Deviation Appeal

The final order partially admits the appeal and reforms the decision based on the application of this provision regarding the determination of the actual financial situation for subsidy calculation.

Arr.t.2014.78 · vd (Art. 12 al. 1 LVLAMal)

Challenge to Health Insurance Premium Subsidies Based on Outdated Income Assessment

The court rejected the appeal because the difference between the RDU calculated based on the actual economic situation and the RDU based on the 2011 tax decision was less than the 20% required by this article to allow the actual situation to be considered.

Arr.t.2013.558 · vd (Art. 12 al. 1 LVLAMal)

Appeal of Health Insurance Subsidy Reduction Based on Unverified Income

The appeal was admitted and the case returned for complementary investigation based on the conditions set out in this article for basing the benefit calculation on the real economic situation.

Arr.t.2013.68 · vd (Art. 12 LVLAMal)

Insured Denied Subsidy Due to Income Aggregation with Non-Spouse Cohabitant

Cited in the reasoning justifying the application of income aggregation for a durable domestic community.

Arr.t.2012.682 · vd (art. 12 LVLAMal)

Health Insurance Subsidy Appeal Based on Household Income Aggregation

The appeal was partially admitted and the case remanded to the lower authority for a new decision based on the applicant's actual economic situation, as assessed under this article.