25 JUIN 1997. An Act to amend the Act of April 11, 1995 to establish the charter of the social insured (1)

Albert II, King of the Belgians,
To all, present and to come, Hi.
The Chambers adopted and We sanction the following:
Article 1. This Act regulates a matter referred to in Article 78 of the Constitution.
Art. 2. In section 2, subparagraph (l), of the Act of 11 April 1995 to establish the charter of the social insured, the following amendments are made:
A) 1°, b) is replaced by the following provision:
"(b) all branches covered under (a), whose application is extended to persons occupied in the public sector, and branches of the public sector that perform a function equivalent to the branches referred to in (a); »;
(b) 2°, (a) is replaced by the following provision:
“(a) ministries, public social security institutions and any body, authority or legal entity of public law that provides social security benefits; »;
C) at 2°, b) the words "and pricing offices of pharmacists' associations" are inserted between the words "social secretariats of employers" and "accredited to collaborate in the application of social security";
(D) 2° is supplemented by a littera (d), which reads as follows:
(d) persons charged by social security institutions referred to in (a), (b) and (c) to maintain a particular directory of persons referred to in Article 6, paragraph 2, of the Act of 15 January 1990 relating to the institution and organization of a Social Security Crossing Bank”;
E) the 7° is replaced by the following provision:
"7° "social insurance": natural persons who are entitled to social benefits, who claim or can claim, their legal representatives and their agents; »;
F) the paragraph is completed as follows:
"8° "decision": the unilateral legal act of individual scope emanating from a social security institution which aims to produce legal effects with respect to one or more social insured persons. »
Art. 3. In section 2, paragraph 2, of the Act, the following amendments are made:
A) the 7° is replaced by the following provision:
"7° "social insurance"; »
B) the paragraph is completed as follows:
"8° "decision". ".
Art. 4. The Dutch title of Chapter II of the Act is replaced by the following title:
"Verplichtingen van de instellingen van sociale zekerheid".
Art. 5. In section 3 of the Act, the following amendments are made:
1° the first sentence of paragraph 1^{er is replaced by the following provision:
"Social security institutions are required to provide to the social insured who makes the written request, any useful information regarding his rights and obligations and to provide initiative to the social insured any additional information necessary to review his or her application or to maintain his or her rights, without prejudice to the provisions of Article 7. »;
2° Paragraph 3 is replaced by the following paragraph:
"It must be precise and complete in order to allow the social insured concerned to exercise all his rights and obligations. »;
3° the words « thirty working days » and « thirty days » are replaced by the words « forty-five days ».
Art. 6. Article 4, paragraph 1er, from the same law, the words "any person" are replaced by the words "any social insured person".
Art. 7. In Article 5 of the Act, the words "the competent institution" are replaced by the words "the competent social security institution".
Art. 8. Section 6 of the Act is replaced by the following provision:
“Art. 6. - Social security institutions must use, in their relations with the social insured, whatever the form, a language that is understandable to the public. »
Art. 9. Section 8 of the Act is replaced by the following provision:
“Art. 8. - Social benefits are granted either ex officio whenever it is materially possible or upon written request.
The King determines what to hear by "materially possible." "
Art. 10. In section 9 of the Act, the following amendments are made:
1st paragraph 1er is replaced by the following provision:
"Without prejudice to the specific legal or regulatory provisions, the application signed by the interested party is filed with the social security institution whose mission is to instruct the institution. »;
2° Paragraph 2 is supplemented as follows:
"The King may establish additional terms or determine cases in which the acknowledgement of receipt must not be issued. »;
3° in paragraph 3, the words "the competent institution" are replaced by the words "the competent social security institution";
Paragraph 5 is replaced by the following provision:
"The King determines which application, introduced in order to obtain a national benefit to a social security regime, is required to obtain the same dependant advantage of another regime. It also determines what to hear by "social security regime". »
Art. 11. In section 10 of the Act, the following amendments are made:
1st paragraph 1er is replaced by the following paragraph:
"Without prejudice to a shorter period of time provided for by specific legal or regulatory provisions and without prejudice to the Act of 25 July 1994 amending the Act of 27 February 1987 on Disability Allowances to expedite the examination of records, the social security institution shall decide no later than four months from the 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 paragraph:
"If the time limit is four months and the institution cannot make a decision within that time limit, it shall inform the applicant of 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 and eighty working days" are replaced by the words "eight months";
5° the article is supplemented by the following paragraphs:
"The deadlines for four or eight months are suspended until the individual or a foreign institution has provided the requested information to the social security institution, which is necessary to make the decision.
The provisions of paragraphs 2 and 3 do not extend the time limits of four or eight months referred to above.
The King shall determine the social security regimes or subdivisions thereof for which a decision relating to the same rights, taken after a review of the legality of the benefits paid, is not considered a decision for the purposes of paragraph 1er. »
Art. 12. In section 11, of the Act, the following paragraph is inserted before paragraph 1:
"The social security institution that must consider an application collects all information that is lacking in order to assess the rights of the social insured. "
Art. 13. An article 11bis, as follows, is inserted in the same law:
"Art. 11bis. - The King may, by order deliberately in the Council of Ministers and after the advice of the National Labour Council, grant an exemption to the provisions of articles 10, 11 and 12 for the procedures in force in certain sectors of social security which offer at least the same guarantees for the social insured. "
Art. 14. Section 12 of the Act is replaced by the following provision:
“Art. 12. - Without prejudice to a shorter period of time provided for by specific legal or regulatory provisions and without prejudice to the Act of 25 July 1994 amending the Act of 27 February 1987 on Disability Allowances with a view to speeding up the examination of records, the payment of benefits shall be made no later than four months from the notification of the award decision and no later than the date on which the terms of payment are met.
In cases where a regulation provides that the benefits awarded are paid only annually, these payments are expected to correspond to the conditions set out in the preceding paragraph, provided that they are made within the year concerned or by the end of February of the following year.
If the payment is not made within the time limit set out in paragraph 1er or in the course of the year as provided for in paragraph 2, and without prejudice to the rights of the applicant to apply to the competent courts, the social security institution responsible for the payment of benefits shall inform the applicant of the reasons for the delay.
As long as the payment has not been made, the applicant is informed every four months of the reasons for the delay.
The King may temporarily carry the period of four months, as provided in paragraph 1 to not more than eight months. »
Art. 15. In section 13 of the Act, the following amendments are made:
1° the words "at articles 11 and 12" are replaced by the words "at articles 10 and 11";
2° the article is supplemented by a paragraph 2, which reads as follows:
"Without prejudice to the possible obligation to inform the social insured of a decision motivated in a language that is 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 an act, may be considered explicitly motivated internally. "
Art. 16. Article 14, paragraph 1erthe following amendments are made:
A) the 2° is replaced by the following provision:
"2° the address of the competent courts";
B) in the 4th, the words "rules" are replaced by the words "content".
Art. 17. In section 15, subparagraph (l), of the Act, the following amendments are made:
1° to 3°, the words "text" are replaced by the words "content";
2° to 5°, the words "the possibility" are replaced by the words "if applicable, the possibility".
Art. 18. Section 16 of the Act is replaced by the following provision:
“Art. 16. - Without prejudice to the specific legal or regulatory provisions, the notification of a decision shall be made by ordinary letter or by the handover of a writing to the individual.
The King may determine the cases in which the notification must be made by registered letter to the position, as well as the terms and conditions for the application of that notification. »
Art. 19. In section 17 of the Act, the following amendments are made:
1st paragraph 1er is replaced by the following provision:
"When it is found that the decision is terminated by an error of law or material, the social security institution is taking the initiative of a new decision producing its effects on the date that the rectified decision should have taken effect, without prejudice to the legal and regulatory provisions on prescription. »;
2° the article is supplemented by a paragraph 3, which reads as follows:
"The preceding paragraph is not applicable if the social insured knows or ought to know, in the sense of the Royal Decree of 31 May 1933 concerning the declarations to be made in respect of grants, allowances and allowances, that he or she has no or more right to a benefit. »
Art. 20. Section 18 of the Act is replaced by the following provision:
“Art. 18. - Without prejudice to the statutory and regulatory limitation provisions, the social security institution may report its decision and take a new decision within the time limit for the introduction of an appeal to the competent court or, if an appeal has been filed, until the proceedings are closed when:
1° on the date on which the benefit was taken, the law was amended by a legal or regulatory provision;
2° a new fact or new evidence affecting the applicant's rights is invoked in the course of a proceeding;
3° it is found that the administrative decision is filled with irregularity or material error. "
Art. 21. An article 18bis, as follows, is inserted in the same law:
"Art. 18bis. - The King determines the social security regimes or the subdivisions of the social security regimes for which a decision on the legality of the benefits paid is not considered a new decision for the application of articles 17 and 18. "
Art. 22. In section 19 of the Act, the following amendments are made:
1° to paragraph 1er :
(a) the words "contentious jurisdiction" are replaced by the word "court";
(b) in the Dutch text, the word "bestuursrechtelijke" is replaced by the word "reglementary";
2° in paragraph 2, the words "Without prejudice to existing legal provisions" are replaced by the words "Without prejudice to specific legal or regulatory provisions";
3° the article is supplemented by a paragraph 3, which reads as follows:
"The King may, by order deliberately in the Council of Ministers and after the advice of the National Labour Council, determine that this article is not applicable to the branches of social security that are familiar with a specific review procedure. "
Art. 23. In section 20 of the Act, the following amendments are made:
A) in paragraph 1:
1° the words "more favourable legal or regulatory provisions" 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 words "institution" are replaced by the words "an institution";
B) paragraph 2 is replaced by the following paragraph:
"If the King, pursuant to Article 11bis, acknowledges a specific procedure, He determines the conditions under which the interests are granted, the debtor of those interests and the time of taking courses of interest. »;
(C) the article is supplemented by a paragraph 3, which reads as follows:
"The interest due in full right referred to in paragraph 1er, are not due to the difference between, on the one hand, the amount of advances paid because the organization does not have the information necessary to make a final decision and, on the other hand, the amount that arises from the final decision, if these advances amount to nonante per cent or more of the amount due on the basis of the final decision. "
Art. 24. In the Dutch text of section 21 of the same law, the word "annuity" is replaced by the word "interest".
Art. 25. An article 21bis, as follows, is inserted in the same law:
"Art. 21bis. - The King may, for the purposes of sections 20 and 21, determine the terms and conditions for calculating interest. It may also set the interest rate without the interest rate being less than the normal rate of advances in non-ceiling current account fixed by the National Bank.
By order deliberately in the Council of Ministers and after the advice of the National Labour Council, the King may, for the purposes of Article 21, assimilate to fraud, dol or fraudulent maneuvers, the failure by the debtor to make a declaration prescribed by a provision that had been communicated to the social insured. The declaration may be prescribed by a legal or regulatory provision or arising from an earlier undertaking. "
Art. 26. In section 22 of the Act, the following amendments are made:
1° to § 1er, the words "Without prejudice to clean rules" are replaced by the words "Without prejudice to clean legal or regulatory provisions";
2° in the French text of § 3, the word "flight" is replaced by the word "dol";
3° in the French text of § 4, the word "paid" is replaced by the word "paid";
4° the article is supplemented by a § 5:
“§ 5. The King may, by order deliberately in the Council of Ministers and after the advice of the National Labour Council, determine that §§ 1er to 4 are not applied to certain branches of social security. "
Art. 27. Section 23 of the Act is replaced by the following provision:
“Art. 23.- Without prejudice to the more favourable deadlines resulting from specific legislations, appeals against decisions taken by the relevant social security institutions in the matter of granting, payment or recovery of benefits must, as soon as they are due, be filed within three months of their notification or the notice of the decision by the social insured in case of absence of notification.
Without prejudice to the more favourable deadlines resulting from specific legislation, any remedy for recognition of a right against a social security institution must also, as soon as it is due, be introduced within three months of the finding of the institution's lack of capacity. "
Art. 28. Article 2, paragraph 1er, 1°, b), of the Act of January 15, 1990 on the institution and organization of a Social Security Crossroads Bank is replaced by the following provision:
"(b) all branches covered under (a), whose application is extended to persons occupied in the public sector, and branches of the public sector that perform a function equivalent to the branches referred to in (a); "
Art. 29. This Act produces its effects on 1er January 1997.
However, the provisions of Article 2, A), do not affect 1er January 1997 only for the branches of health care and public sector pensions referred to in article 38 of the Act of 5 August 1978 of economic and budgetary reforms. For other plans, they come into force on 1er January 1999.
Promulgate this law, order that it be clothed with the seal of the State and published by the Belgian Monitor.
Given in Brussels on 25 June 1997.
By the King:
Deputy Prime Minister
Minister of Finance and Foreign Trade,
Ph. MAYSTADT
Minister of Public Health and Pensions,
Mr. COLLA
Minister of Employment and Labour,
Ms. M. SMET
The Minister of Social Affairs,
Ms. M. DE GALAN
Minister of Agriculture
and Small and Medium Enterprises,
K. PINXTEN
Minister of Public Service,
A. FLAHAUT
The Secretary of State for Security,
social integration and the environment,
J. PEETERS
Seal of the state seal:
Minister of Justice,
S. DE CLERCK
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