Facts
The present judgment concerns a dispute between the Winterthur insurance company and the insured person A. regarding the right to the transitional pension of the accident insurance. The central issue is to determine at what point the right to this pension expires when the IV has issued a negative decision regarding vocational rehabilitation measures, but this decision is subject to an appeal.
Winterthur argued that the transitional pension should only be paid until the moment the IV renders its decision on the rehabilitation measures, and not until this decision becomes enforceable after exhaustion of the appeal process. According to Winterthur, the insured person could thus unduly prolong their right to the transitional pension.
However, the Federal Court rejected this argument and ruled that the right to the transitional pension expires when the IV's negative decision on the rehabilitation measures becomes enforceable, i.e. 30 days after its notification.
Considerations
The Federal Court first noted that the wording of the law and the ordinance was not perfectly clear on this point. However, a systematic and teleological interpretation of these provisions shows that the legislator's intention was to guarantee the payment of the transitional pension throughout the procedure leading to the IV's decision, including in the event of an appeal.
Indeed, the obligation of the accident insurer to pay benefits depends on the IV's decision on the right to rehabilitation measures. It would therefore be contrary to the legislator's will to limit the right to the transitional…