Legal principle of veto: the choice of the insured treatment outside the "health insurance" borne by the differences in costs
The Court of Cassation affirmed an important principle during its consideration of Appeal No. 10679 of 79/2018/02/06 session. – The Labor Chambers – that the health insurance is the body entrusted with the treatment of the injured worker or the patient, and the choice of the insured or injured to voluntarily treat himself outside the public body For health insurance at his own expense and without reference to the therapeutic entity, he shall bear the differences in the costs of treatment (articles 85 and 86) of the Social Insurance Law 79 of 1975.
The court stated that the provisions of Articles 85 and 86 of the Social Insurance Law promulgated by Law No. 79 of 1975 stipulate that the legislator has determined the body entrusted with treating the patient or the patient and his medical care until he is cured or proven incapacitated, the General Authority for Health Insurance, because of its medical means and possibilities And the therapeutic work it is assigned to perform its humanitarian tasks.
The court allowed the transfer of some special cases to specialized hospitals when they do not have the means to provide all aspects of medical care in all specialties to all insured. In order to do so, if the insured chooses to treat himself outside the body General of Health Insurance at his own expense and without reference to the therapeutic body (General Authority for Health Insurance) or prove that he was prevented from treatment, he must bear the differences in the cost of treatment and then return it. If he wishes to – the employer, without any of the health insurance or social insurance.
The court added, "Since it was fixed papers that the first contestant has treated himself in a private hospital without reference to the General Authority for Health Insurance or the appellant body does not commit either of these bodies to refund the costs of treatment, and the contested judgment violated this consideration and supported the provision In order to force the appellant to lead the first litigant to the sum of 15,000 pounds as a payment for medical and therapeutic care, he shall be in contravention of the law. "(Appeal No. 10679, 79, 2018/02/06).
Related topics
(tt) health insurance (t) social insurance law (t) private hospitals
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