Fuente: © European Union
http://europa.eu.int

EU: Internal Market: Commission requests Belgium to amend law on supplementary health insurance provided by private sickness funds

/noticias.info/ The European Commission has formally requested Belgium to amend its national rules so that the private sickness funds (mutualités/ziekenfondsen) comply with the EU insurance directives when they offer complementary health insurance cover outside the scope of obligatory social security. In Belgium, private sickness funds operate under specific national rules and are not subject to EU rules relating to the solvency, supervision and funding of insurance providers. The Commission is concerned that this could result in differing levels of policyholder protection and market distortions. This request takes the form of a 'reasoned opinion', the second stage of the infringement procedure under Article 226 of the EC Treaty. If there is no satisfactory reply within two months, the Commission may refer the matter to the European Court of Justice.

In December 2006 the Commission sent a letter of formal notice to Belgium (see IP/06/1781) concerning the activities of the Belgian private sickness funds (the mutualités" or "ziekenfondsen) in the field of complementary health insurance outside the scope of obligatory social security.

The Commission argued that the First and Third Non-Life Insurance Directives (Council Directives 73/239/EEC[1] and 92/49/EEC[2]) are applicable to the Belgian private sickness funds to the extent that those funds are offering complementary health insurance in the market. The Commission maintained that the Belgian legislation applicable to private sickness funds (the Act of 6 August 1990) has not correctly and completely implemented the provisions of the above Directives, as far as the sickness funds' complementary health insurance activities are concerned.

One of the issues raised in the Commission's letter, namely the "small risks" cover for the self-employed, has now been resolved, since Belgium has now brought this cover within the scope of the obligatory social security regime.

However, the Commission's other concerns have not been addressed.

The Commission does not call into question the role of the private sickness funds in the statutory health insurance scheme; nor does it question the way private sickness funds are set up and regulated as far as the provision of statutory health insurance is concerned. This is a matter which falls outside the scope of harmonised EU insurance legislation. Nor is the Commission seeking to prevent the private sickness funds from offering complementary health insurance cover. However, the Commission believes that such activities must be conducted in accordance with the pertinent provisions of the First and Third Non-Life Directives because these offer better guarantees for policyholders and their insured relatives, in particular in the form or more stringent solvency requirements.

The Commission is therefore requesting Belgium to amend the rules governing the operation of the private sickness funds in the field of supplementary health insurance cover to bring them into line with EU law.

The latest information on infringement proceedings concerning all Member States can be found at:

http://ec.europa.eu/community_law/index_en.htm



[1] First Council Directive (73/239/EEC) of 24 July 1973 on the coordination of laws, Regulations and administrative provisions relating to the taking-up and pursuit of the business of direct insurance other than life assurance, OJ L 228, 16.8.1973, p.3.

[2] Council Directive 92/49/EEC of 18 June 1992 on the coordination of laws, regulations and administrative provisions relating to direct insurance other than life assurance and amending Directives 73/239/EEC and 88/357/EEC (third non-life insurance Directive), OJ L 228, 11.8.1992, p.1. notas_de_prensa_archivo