Case 1997-020

C. C., n°19967-020f, 15 April 1997
Download Judgment: English French Flemish
Country: Belgium
Region: Europe
Year: 1997
Court: Court constitutionnelle [Constitutional Court of Belgium]
Health Topics: Health systems and financing
Human Rights: Freedom from discrimination
Tags: Health care professionals, Health care workers, Health expenditures, Health funding, Health insurance, Health regulation, Health spending, Social security, Subsidies

The professional Union of Belgian and International Insurance Companies (“UPEA”) introduced a request to annul articles 24, 4, and 25 (the “impugned provisions”) of the law dated December 20, 1995 (the “contested law”), which pertained to mandatory healthcare and indemnity insurance.

UPEA asserted that article 24, 4, of the contested law conferred to certain physician pension accounts a competitive advantage that constituted discrimination in violation of articles 10 and 11 of the Constitution. UPEA further asserted that, with respect to the impact such provision had on foreign insurance companies, article 24, 4 of the contested law restricted the free provision of services in violation of Articles 6 and 59 of the Treaty of Rome and certain domestic directives.

Concerning article 25 of the contested law, UPEA argued that the State guarantee of the Physicians Welfare Contingency Fund’s solvency margin conferred a competitive advantage, which also constituted discrimination against similarly situated insurance companies. The UPEA further claimed that passing the contested law without first notifying the European Commission constituted a breach of articles 92 and 93 of the Treaty of Rom (requiring each member state to notify the European Commission of aid projects). By adopting the provision being contested without the Commission having been notified in advance, UPEA argued that legislator had deprived UPEA of a significant guarantee provided for by community law to ensure the principle of fair competition.

The Court rejected UPEA’s request to annul impugned provisions of the contested law.

The Court found that the difference in treatment between the Physicians Welfare Contingency Fund and the insurance companies, which resulted from article 24, 4, was not unjustified. The Physician’s Welfare Contingency Fund operated according to a financing system based on the principle of distribution, i.e., system of solidarity with working physicians contributing for the benefit of those not working. The perpetuation of such a system required the continuation of a certain relationship between the number of contributors and the number of beneficiaries. In order to contend with the growing financial problems the Physicians Welfare Contingency Fund was facing, certain measures to ensure the fiscal solvency of the fund were required. Moreover, the Court noted that the constitutional rules of non-discrimination did not forbid different treatment of various categories of persons where such treatment relied on objective criterion and was reasonably justified. Rather, the principle of equality was violated where there was no reasonable relation of proportionality between the means employed and the intended goal.

The Court further determined that t the activities of the Physicians Welfare Contingency Fund should not be considered services under the Rome Treaty, as such activities were not services of an economic nature provided in exchange for compensation. Thus, such activities did not fall under the purview of the directives cited by the petitioner.

The Court found that the petitioner’s argument was also not founded with respect to article 25. Although the Court noted that article 25 did result in a difference in treatment with respect to traditional insurance companies and the Physicians Welfare Contingency Fund, it determined that such difference was justified because of the transition from the solidarity technique to the capitalization technique. To contend with the financial consequences of such a transition and to ensure the solvency margin of the Physician Welfare Contingency fund, a State guarantee had to be expected (though such guarantee would draw to a close at the end of the transitional period). The Court concluded that it was the legislator’s responsibility to undertake measures that were deemed necessary to guarantee the financial balance of an organization that was part of the framework of the social security system.

The Court also rejected that the argument that the impugned provisions should not have been passed without notification to the European Commission; it noted that the petitioner’s complaint on this matter pertained not to the content of the law but to its formulation which lay outside of the competence of the Court.



“The result of the preceding is that the petitioning party is wrong in contending that he insurance companies would be exercising identical and competing actives and would be subjected to the same financing system and the same obligation toward their affiliates to achieve results as the authorized retirement fund.” Page 14.

“Il résulte de ce qui précèdequec'est à tort que la partierequérantesoutientque les sociétésd'assurancesexerceraient des activitésidentiques et concurrentes et seraientsoumises au mêmesystème de financement et à la même obligation de résultatenversleursaffiliésque la caisse de pension agréée.”

“Uitwatvoorafgaatvolgtdat de verzoekendepartij ten onrechtebeweertdat de verzekeringsmaatschappijenidentieke en concurrerendeactiviteitenzoudenuitoefenen en onderworpenzoudenzijnaanhetzelfdefinancieringssysteem en aandezelfderesultaatsverbintenis ten aanzien van hunaangeslotenledenals het erkendepensioenfonds.”


“The Article 25 undertaken from the law dated Decemeber 20, 1995, which only grants a State guarantee to the Physicians Welfare Contingency Fund, results in a difference in treatment with respect to traditional insurance companies which do not benefit from the same guarantee.”  Page 15

“L'article 25 entrepris de la loi du 20 décembre 1995 n'accordantunegarantie de l'Etatqu'à la seuleCaisse de prévoyance des médecins, il en résulteunedifférence de traitement avec les entreprisesd'assurancestraditionnelles qui ne bénéficient pas de la mêmegarantie.”

Aangezien het bestredenartikel 25 van de wet van 20 december 1995 enkeleenstaatswaarborgtoekentaan de Voorzorgskas van de geneesheren, vloeitdaaruiteenverschil in behandelingvoort ten opzichte van de traditioneleverzekeringsondernemingen die nietdezelfdewaarborggenieten.”


“The petitioning party reproaches the authors of the law undertaken for not having submitted the project which it considers to be a measure of assistance in the sense of the aforementioned provisions to the European Community Commission. Its complaint does not pertain to the content of the law being contested, but actually on its formulation process. It lies therefore outside the competence of the Court.” Page 16

“La partierequérantereproche aux auteurs de la loientreprise de n'avoir pas soumis à la Commission des Communautéseuropéennes le projet de cequ'elleconsidèrecommeunemesured'aide au sens des dispositions précitées. Son grief ne porte pas sur le contenu de la loiattaquéemaisbiensur son processusd'élaboration. Il estdoncétranger à la compétence de la Cour.”

“Het staataan de wetgever de maatregelentenemen die hijnodigoordeeltom het financieelevenwichttewaarborgen van eeninstelling die past in het kader van het stelsel van de socialezekerheid. Het verschil in behandelingtussen de Voorzorgskas van de geneesheren, enerzijds, en de verzekeringsmaatschappijen, anderzijds, die daar het gevolg van is, is verantwoordom de in B.6.1 en B.6.2 uiteengezetteredenen.”