Law Amending The Law Of 11 April 1995 Establishing The Charter Of The Social Insured (1)

Original Language Title: Loi modifiant la loi du 11 avril 1995 visant à instituer la charte de l'assuré social (1)

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Posted the: 1997-09-13 Numac: 1997022622 Ministry of Social Affairs, of the health public and of the environment 25 June 1997. Law amending the law of 11 April 1995 establishing the Charter of the social insured (1) Albert II, King of the Belgians, to all, present and to come, hi.
The Chambers have adopted and we endorse the following: Article 1. This Act regulates a matter referred to in article 78 of the Constitution.
S. ((2 A article 2, 1st paragraph, of the law of 11 April 1995 establishing the Charter of the insured, the following changes are made: A) 1 °, b) is replaced by the following provision: «b) (all the branches referred to in a)(, dont l'application est étendue àles personnes occupées dans le secteur public, et les branches dele de secteur public qui remplissent une fonction équivalente àles branches visées sous le a);
»;
B) 2 °, a) is replaced by the following provision: «a) ministries, public institutions of social security as well as any agency, authority or any legal person of public law that grants social security benefits; »;
(C) to the 2 °, b) the words "and pricing of pharmacists associations offices" are inserted between the words 'social secretariats of employers' and 'authorized to collaborate in the implementation of social security ';
"(((((D) 2 ° is supplemented by a d littera), as follows: d) persons referred to in the a), (b) social security institutions) and c) to keep a particular directory of persons referred to in article 6, paragraph 2, 2 °, of the law of 15 January 1990 on the institution and the Organization of a Crossroads Bank for social security."
7 ° e) is replaced by the following provision: «7 ° "insured": individuals who are entitled to social benefits, claiming there or can claim, their legal representatives and their agents; »;
(F) paragraph is completed as follows: «8 ° 'decision': the unilateral legal act of individual scope from an institution of social security and the aim of producing legal effects with respect to one or more insured. ".
» Art. 3. in article 2, paragraph 2, of the Act, the following changes are made: has) 7 is replaced by the following provision: «7 ° 'insured ';
(' B) paragraph is completed as follows: «8 ° 'decision'. »..
S.
4. the Dutch title of chapter II of the Act is replaced by the following: «Verplichtingen van instellingen van social zekerheid '.
S. 5A article 3 of the Act, the following changes are made: 1 ° the first sentence of paragraph 1 is replaced by the following provision: "social security institutions are required to provide the social insured that in fact the written request, any relevant information concerning their rights and obligations and to communicate initiative the social insured any further information necessary for the examination of his application or maintain its rights". , without prejudice to the provisions of article 7.
»;
2 ° paragraph 3 is replaced by the following subparagraph: "it must be accurate and complete to enable the insured concerned to exercise all of its rights and obligations. »;
3 ° "thirty days" and "30 days" shall be replaced by the words "45 days".
S. 6 in article 4, paragraph 1, of the Act, the words 'any person' shall be replaced by the words "any insured social.
S. 7 article 5 of the Act, the words "competent institution" are replaced by the words "the competent social security institution.
S. 8. article 6 of the Act is replaced by the following provision: «art.» 6. - social security institutions must, in their relations with the insured, regardless of the form, use a language understandable to the public. » Art.
9. article 8 of the Act is replaced by the following provision: «art.» 8 - social benefits are granted either office whenever it is practicable or upon written request.
The King determines what is meant by 'materially possible. ».

S. 10A article 9 of the Act, the following changes are made: 1 ° 1st paragraph is replaced by the following provision: "without prejudice to the legal or regulatory provisions, the application signed by the person concerned shall be lodged with the social security institution whose mission is to instruct him.» »;
2 ° paragraph 2 is supplemented as follows: «the King can set additional terms or determine the cases in which the acknowledgement of receipt shall not be issued. »;
3 ° in paragraph 3, 'competent institution' shall be replaced by the words "the competent social security institution."
4 ° paragraph 5 is replaced by the following provision: "the King determines what application, obtaining a national advantage to a social security scheme, worth request to obtain the same benefit dependant of another plan. It also determines what is meant by "social security system. » Art. 11 A section 10 of the Act, the following changes are made: 1 ° 1st paragraph is replaced by the following paragraph: "without prejudice to a shorter period provided for by legal or regulatory provisions specific and without prejudice to the law of 25 July 1994 amending the allowances for disabled persons act of 27 February 1987 to expedite the examination of the dossiers. the social security institution statue at the latest within four months of receipt of the application or the fact giving rise to the ex officio examination referred to in article 8. »;.
2 ° paragraph 2 is replaced by the following subparagraph: "If the time is four months and the institution may not take a decision within that period, it inform the applicant in him stating the reasons. »;
3 ° in paragraph 3, the words "social institution" are replaced by the words "social security institution";
4 ° in paragraph 4, the words "one hundred eighty days» are replaced by the words 'eight months '.
5 ° article is supplemented by the following paragraphs: «four or eight months periods shall be suspended as long as the person concerned or a foreign institution have failed completely to the social security institution the requested information necessary for taking the decision.
The provisions of paragraphs 2 and 3 are not extending the above four or eight months time.
The King determines social security schemes or subdivisions thereof for which a decision on the same rights, taken following a review of the legality of benefits paid, is not considered as a decision for the purposes of paragraph 1.
» Art. 12. in article 11 of the Act, the following paragraph is inserted before the first paragraph: "the institution of social security which will examine an application collects initiative all reports default order to enjoy the rights of the insured. ».
S.
13 an article 11bis, as follows, shall be inserted in the Act: «art.» 11bis. - the King may, by Decree deliberated in the Council of Ministers and after receiving the opinion of the national labour Council, grant a derogation from the provisions of articles 10, 11 and 12 for the procedures in force in some areas of social security, offering at least the same guarantees for the insured.
».
S. 14. article 12 of the Act is replaced by the following provision: «art.» 12. - without prejudice to a shorter period provided for by legal or regulatory provisions specific and without prejudice to the law of 25 July 1994 amending the law of 27 February 1987 relating to allowances for the disabled to accelerate the examination of the dossiers, it is for the payment of benefits no later than within four months of notification of the decision to grant and at the earliest from the date on which the conditions for payment are filled.
In cases where a regulation provides that granted benefits are paid annually, these payments are supposed to correspond to the conditions laid down in paragraph above, for as much as they are carried out in the course of the year concerned or at the latest the end of February of the following year.
If payment is not made within the period prescribed in paragraph 1 or in the course of the year as provided in paragraph 2, and without prejudice to the rights of the applicant to enter the courts, the institution of social security for the payment of benefits shall inform the applicant, indicating the reasons for the delay.
As long the payment has not been made, the applicant is informed every four months on the reasons for the delay.
The King may temporarily bring the period of four months prescribed in paragraph first, to more than eight months. » Art. 15 A article 13 of the Act, the following changes are made: 1 ° "in articles 11 and 12' shall be replaced by the words" articles 10 and 11 ".
2 ° article is supplemented by a paragraph 2, as follows: "without prejudice to the possible obligation to inform the insured of a decision motivated in a language understandable to the public, the King may determine under what conditions, categories of decisions taken by or with the help of computer programs, in the absence of Act, may be considered as being explicitly motivated internally. ''
».

S. 16. in article 14, paragraph 1, of the same Act the following changes are made: has) 2 ° is replaced by the following paragraph: "2 ° address competent jurisdictions";
(B) in the 4th, 'provisions' shall be replaced by the words "the content".
S. 17 A section 15, paragraph 1st, of the Act, the following changes are made: 1 ° to 3 °, 'the text' shall be replaced by the words "the content";
2 ° to 5 °, the words 'the possibility' shall be replaced by the words "where appropriate, the possibility".
S. 18. article 16 of the Act is replaced by the following provision: «art.» 16. - without prejudice to the legal or regulatory provisions, notification of a decision made by ordinary letter or the furnishing of a writing to the person concerned.
The King may determine the cases in which notification must be done by registered letter at the post office, as well as detailed rules for the application of this notification. » Art. 19A section 17 of the Act, the following changes are made: 1 ° 1st paragraph is replaced by the following provision: "when it is found that the decision is vitiated by an error of law or material, the social security institution initiative takes a new decision with effect on the date which the rectified decision should have come into effect, and this without prejudice to limitation legal and regulatory provisions." »;
2 ° article is supplemented by a paragraph 3 as follows: "the preceding paragraph is not application if the insured knows or ought to have known, in the direction of the royal decree of 31 May 1933 on declarations to make grants, benefits and allowances, there is not or no longer entitled to the entirety of a benefit. » Art. 20. article 18 of the Act is replaced by the following provision: «art.» 18. - without prejudice to limitation legal and regulatory provisions, the social security institution may rescind its decision and take a new within the time limit for lodging an appeal before the competent court or, if an appeal has been lodged, until the closure of the debate when: 1 ° to the date being the provision, law was amended by law or regulatory;
2 ° a new fact or new evidence bearing on the applicant's rights are invoked during the proceedings;
3 ° it is found that the administrative decision is vitiated by irregularities or clerical error. ».
S. 21 an article 18bis, as follows, shall be inserted in the Act: «art.» 18bis.-the King determines social security schemes or subdivisions thereof for which a relative to the rights same decision following a review of the legality of benefits paid, is not considered as a new decision for the purposes of articles 17 and 18. ».
S. 22. A section 19 of the Act, the following changes are made: 1 ° 1st paragraph: a) "contentious jurisdiction" shall be replaced by the word "jurisdiction".
(b) in the Dutch text, the word "bestuursrechtelijke" is replaced by the word "regulatory".
2 ° in paragraph 2, the words "without prejudice to existing legal provisions" are replaced by the words "without prejudice to the legal or regulatory provisions specific";
3 ° article is supplemented by a paragraph 3 as follows: "the King may, by Decree deliberated in the Council of Ministers and after receiving the opinion of the national Council of labour, determine that this article does not apply to the branches of social security who know a specific revision procedure. ».
S.
23. A section 20 of the Act, the following changes are made: has) in 1st paragraph: 1 ° the words ' legal or regulatory provisions more favourable and "are inserted between the words"without prejudice"and" the provisions of the law of 25 July 1994.
2 ° in the french text, the words 'social beneficiaries' are replaced by the words "social insured beneficiaries."
3 ° 'the institution' shall be replaced by the words "an institution";
(B) paragraph 2 is replaced by the following subparagraph: "If the King, in application of article 11bis, recognizes a specific procedure, it determines the conditions in which interests are granted, the debtor of such interest and the time of taking of course of relevance. '' »;
(C) article is supplemented by a paragraph 3 as follows: "the interest of right, referred to in paragraph 1, are not due on the difference between, on the one hand, the amount of advances because the body does not have the information necessary to take a final decision, and on the other hand, the amount resulting from the final decision. If these advances amounted to ninety per cent or more of the amount due on the basis of the final decision. ».
S.
24. in the Dutch text of article 21 of the Act, the word "annuity" is replaced by the word "interest".
S. 25 article 21bis as follows, shall be inserted in the Act: «art.» 21A. - the King may, for the purposes of sections 20 and 21, determine the procedure for the calculation of interest. It can also set the interest rate without that it could be lower than the normal rate of advances in current account off ceiling fixed by the National Bank.
By order deliberated in Council of Ministers and after the opinion of the national labour Council, the King may, for the purposes of article 21, equate to fraud, deceit or fraudulent, the failure of the debtor to make a statement prescribed by a provision which had been communicated to the insured. The declaration may be prescribed by a statutory or regulatory provision or be the result of a prior commitment. ».
S. 26 in section 22 of the Act, the following changes are made: 1 ° in the § 1, the words "without prejudice to the specific rules" are replaced by the words "without prejudice to legal or regulatory own."
2 ° in the french text of paragraph 3, the word "theft" is replaced by the word 'fraud '.
3 ° in the french text of § 4, the word "paid" is replaced by the word "paid";
4 ° article is supplemented by a § 5: "§ § 5 5.» The King may, by Decree deliberated in the Council of Ministers and after receiving the opinion of the national Council of labour, determine as §§ 1 to 4 are not applied to certain branches of social security. ».
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27. article 23 of the Act is replaced by the following provision: «art.» 23. - without prejudice to more favourable time limits resulting from specific legislation, appeals against decisions made by the social security institutions competent for granting, payment or recovery of benefits, must, under penalty of forfeiture, be introduced within three months of their notification or taking knowledge of the decision by the insured in the absence of notification...

Without prejudice to more favourable time limits resulting from specific legislation, any action for recognition of a right against a social security institution shall also, under penalty of forfeiture, be introduced within a period of three months from the date of the finding of deficiency of the institution. ».
S. 28. article 2, paragraph 1, 1 °, b), Act of 15 January 1990 on the institution and the organisation of a Crossroads Bank for social security is replaced by the following provision: «b) (all the branches referred to in a)(, dont l'application est étendue àles personnes occupées dans le secteur public, et les branches dele de secteur public qui remplissent une fonction équivalente àles branches visées sous le a); ».
S. 29. this Act has effect on 1 January 1997.
However, the provisions of article 2, A), shall have effect on January 1, 1997 to the branches of health care and pensions of the public sector referred to in article 38 of the Act of August 5, 1978, of economic and budgetary reforms. For the other plans, they come into force on January 1, 1999.
Promulgate this Act, order that it be under the seal of the State and published by le Moniteur.
Given in Brussels, 25 June 1997.
By the King: the Deputy Prime Minister and Minister of finance and foreign trade, Ph.
The Minister of public health and Pensions, Mr MAYSTADT COLLA the Minister of employment and labour, Mrs M. SMET the Minister of Social Affairs, Ms. DE GALAN the Minister of Agriculture and small and medium-sized enterprises, K.
PINXTEN public service Minister A. FLAHAUT. the Secretary of State security, Social Integration and the environment, J. PEETERS sealed with the seal of State: the Minister of Justice, S. DE CLERCK for consultation of the footnote page, see image