Refusal of the private insurer to appeal against the decision of the accident insurer

Facts

R. is insured with the Mutuelle Valaisanne for the compulsory health insurance and with the Union Suisse, Compagnie générale d'assurances, for occupational and non-occupational accident insurance. Her employer has taken out a daily allowance insurance in case of illness, accident or maternity with SWICA Organisation de santé. On February 27, 1997, R. was the victim of a sexual assault. The Union Suisse refused to pay her accident insurance benefits, considering that the event did not constitute an accident. SWICA filed an appeal against this decision with the Insurance Tribunal of the canton of Valais, which declared the appeal inadmissible. SWICA then filed an administrative law appeal against this judgment.

Considerations

The Federal Tribunal considered that Art. 129 of the Ordinance on Accident Insurance (OLAA) concerns only the right of appeal of social insurers, to the exclusion of private insurers who do not have the status of an interested party within the meaning of this provision. Although SWICA has advanced daily allowances to its insured, it is not entitled to invoke the provisions of the OLAA relating to the obligation to notify and the legitimacy to appeal, which only apply to the relationship between social insurers.

Furthermore, SWICA cannot invoke Art. 103(a) of the Judicial Organisation Act (OJ) to justify its right to appeal, as it is not sufficiently…