Facts
This decision concerns a dispute regarding the reimbursement of unjustly paid health insurance benefits. CSS Insurance had requested D. to reimburse benefits that it had paid him before January 1, 2003, the date of entry into force of the Federal Act on the General Part of Social Security Law (LPGA). The decision on the objection was rendered after this date.
The central question is which law applies to the reimbursement of the benefits: the one in force before January 1, 2003 (Federal Act on Old-Age and Survivors' Insurance, LAVS) or the new LPGA. The Insurance Court of the Canton of Valais ruled in favor of the application of the LPGA, a decision that the Federal Supreme Court must examine.
Considerations
The Federal Supreme Court considers that the question of the applicable law ratione temporis is not decisive in this case. In fact, the principles applicable to reimbursement under the LPGA are derived from the previous regulations and case law, in particular from Article 47 paragraph 1 LAVS, which was applicable by analogy before the entry into force of the LPGA.
Thus, the obligation to reimburse always presupposes that the conditions for a reconsideration or procedural revision of the decision by which the benefits were granted are met, in accordance with the case law…