SZV loses another lawsuit over sickness payments

POSTED: 04/10/15 12:16 PM

St. Maarten – The Court in First Instance ordered the bureau for social health insurance SZV to resume paying sickness benefits to a woman who suffers from an advanced stage of breast cancer. According to the doctor who treats the woman, her perspective is poor. The court’s decision is not open to appeal.

The plaintiff – represented by attorneys Cor Merx and Roy Moes – became unfit for work due to her medical condition on March 18 of last year. Before that date, the woman had to report unfit for work several times because of the developing cancer. On March 4, her oncologist described the patient’s prognosis as very poor.

One-and-a-half month earlier, on January 26 of this year, the SZV declared that the woman’s right to sickness payments would expire per February 26.

The conflict hinges on the interpretation of article 5 of the national ordinance on health insurance. This article states that the right to sickness payment expires after two years.

In a similar case, the court ruled on December 8 of last year that this 2-year period ends after an uninterrupted period of illness of two years after the moment an employee reports sick, or when multiple periods of absence of work attributed to the same illness amount to two years.

The plaintiff argued to the court that after every period of sickness, the counter goes back to zero. This would put the moment when the right to sickness benefits expires at a later moment. In the 2014 law suit, the SZV argued that the two-year period begins when an employee reports ill for the first time for a given illness. The right to payment expires according to the SZV two years after that date, even if the employee has worked during different periods after the first sickness-leave.

The court ruled that, in a regular court procedure, both parties still have a chance to win. Weighing the interest of both parties however – the restitution risk versus the interest of the plaintiff to continued payment – the court ruled that the position of the plaintiff prevails.

The court therefore suspended the SZV-decree to stop the payment until there is a ruling in the regular court procedure. The court ordered the SV to pay the sickness benefits as of January 26 until the date of the aforementioned ruling. It also ordered SZV to pay 1,400 guilders (just over $780) for the salary of the plaintiff’s legal representatives.

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