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Against said resolution, the plaintiff presented a prior claim that was also rejected in the resolution upon receipt of form E126 certified by the competent institution of the Member State of stay, in this case France, that the amount of expenses derived from the care provided is not subject to refund.
The actor filed a lawsuit against the INSS, the General Email Data Social Security Treasury (TGSS), the employer and against the company's mutual insurance company. The Social Court No. 2 of Logroño upheld the claim and declared the plaintiff's right to reimbursement of the medical expenses paid by him . Likewise, he ordered the defendants to reimburse the plaintiff the amount that he paid for the health care benefit.
Against said ruling, the INSS and TGSS filed an appeal requesting that the lower court resolution be revoked and, in its place, a new one be issued rejecting the claim filed by the plaintiff.
The Superior Court of Justice of La Rioja has rejected the appeal and confirmed the appealed sentence, reasoning that it is in accordance with community and national law.
The Court rules that the actor's health care cannot be limited to the expenses billed by the French Ministry of Finance because they are covered by the legislation applicable to its national citizens, but rather the expenses billed by virtue of the co-payment, in excess of those derived from the health care provided on an urgent and vital basis, must be reimbursed by the INSS .
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