«(Social security – Hospital treatment of a pensioner during a stay in a Member State other than the State in which he resides – Conditions for funding – Articles 31 and 36 of Regulation (EEC) No 1408/71 – Articles 31 and 93 of Regulation (EEC) No 574/72)»

1.. Social security for migrant workers – Sickness insurance – Entitlement to benefits in the event of a stay outside the competent Member State – Pensioners staying outside their Member State of residence – Provisions applicable (Council Regulation No 1408/71, Arts 22(1)(a) and 31)

2.. Social security for migrant workers – Sickness insurance – Entitlement to benefits in the event of a stay outside the competent Member State – Pensioners staying outside their Member State of residence – Entitlement to benefits in kind – Conditions (Council Regulation No 1408/71, Art. 31)

3.. Social security for migrant workers – Sickness insurance – Entitlement to benefits in the event of a stay outside the competent Member State – Pensioners staying outside their Member State of Residence – Obligation of cooperation on the institution of the place of stay and that of the place of residence (Art. 10 EC; Council Regulation No 1408/71, Art. 84)

4.. Social security for migrant workers – Sickness insurance – Entitlement to benefits in the event of a stay outside the competent Member State – Pensioners staying outside their Member State of residence – Refusal wrongly interposed by the institution of the place of stay – Obligations resulting for the institution of the place of residence (Council Regulations No 1408/71, Art. 31, and No 574/72, Art. 31)

JUDGMENT OF THE COURT 25 February 2003 (1)

((Social security – Hospital treatment of a pensioner during a stay in a Member State other than the State in which he resides – Conditions for funding – Articles 31 and 96 of Regulation (EEC) No 1408/71 – Articles 31 and 93 of Regulation (EEC) No 574/72))

In Case C-326/00,

REFERENCE to the Court under Article 234 EC by the Diikitiko Protodikio Thessalonikis (Greece) for a preliminary ruling in the proceedings pending before that court between

and

on the interpretation of Articles 31 and 36 of Council Regulation (EEC) No 1408/71 of 14 June 1971 on the application of social security schemes to employed persons, to self-employed persons and to members of their families moving within the Community, as amended and updated by Council Regulation (EEC) No 2001/83 of 2 June 1983 (OJ 1983 L 230, p. 6), as amended by Council Regulation (EC) No 3096/95 of 22 December 1995 (OJ 1995 L 335, p. 10), of Articles 31 and 93 of Council Regulation (EEC) No 574/72 of 21 March 1972 laying down the procedure for implementing Regulation (EEC) No 1408/71, as amended and updated by Regulation No 2001/83, as amended by Regulation No 3096/95, of Articles 56 and 59 of the EC Treaty (now, after amendment, Articles 46 EC and 49 EC) and 60 of the EC Treaty (now Article 50 EC), and of Article 1 of the Protocol to the European Convention on the Protection of Human Rights and Fundamental Freedoms,

THE COURT,,

composed of: G.C. Rodríguez Iglesias, President, M. Wathelet, R. Schintgen and C.W.A. Timmermans (Presidents of Chambers), C. Gulmann, D.A.O. Edward, A. La Pergola (Rapporteur), P. Jann, V. Skouris, F. Macken, N. Colneric, S. von Bahr and J.N. Cunha Rodrigues, Judges,

Advocate General: D. Ruiz-Jarabo Colomer,

after considering the written observations submitted on behalf of:

having regard to the Report for the Hearing,

after hearing the oral observations of Idryma Koinonikon Asfaliseon (IKA), represented by D.G. Anastassopoulos; the Greek Government, represented by S. Spyropoulos and I. Bakopoulos; the Spanish Government, represented by N. Díaz Abad; the Irish Government, represented by A.M. Collins; the Netherlands Government, represented by H.G. Sevenster, acting as Agent; the Finnish Government, represented by T. Pynnä, acting as Agent; the United Kingdom Government, represented by D. Lloyd-Jones QC; and the Commission, represented by H. Michard and M. Patakia, acting as Agents, at the hearing on 10 September 2002,

after hearing the Opinion of the Advocate General at the sitting on 15 October 2002,

gives the following

Community law

...

shall be entitled:

....

...

In the latter case, the lump-sum payments shall be such as to ensure that the refund is as close as possible to actual expenditure.

...

If the institution of the place of stay and the competent institution are bound by an agreement providing either that no refund, or that a lump-sum refund of benefits provided, in pursuance of Articles ... 31 of the Regulation, be made, the institution of the place of stay shall, in addition, be required to transfer to the competent institution the amount to be refunded to the person concerned in pursuance of the provisions of paragraph 1.

National law

The relevance of the question

The scope of Article 31 of Regulation No 1408/71

The implementation in practice of Article 31 of Regulation No 1408/71

Funding of the treatment covered by Article 31 of Regulation No 1408/71

On those grounds,

THE COURT,

in answer to the questions referred to it by the Diikitiko Protodikio Thessalonikis by order of 31 January 2000, hereby rules:

Rodríguez Iglesias

Wathelet

Schintgen

Timmermans

Gulmann

Edward

La Pergola

Jann

Skouris

Macken

Colneric

von Bahr

Cunha Rodrigues

Delivered in open court in Luxembourg on 25 February 2003.

R. Grass

G.C. Rodríguez Iglesias

Registrar

President