46 UR II 22/06•Necessity of counsel for a care-insurance objection
46 UR II 22/06Tribunale di primo grado1 giu 2006Diritto delle assicurazioni socialiRespinto
Estratto da Omnilex
The applicant appealed the Eschweiler Local Court’s 27 March 2006 refusal of advisory assistance in connection with a care insurer’s decision denying classification at a care level. The court dismissed the appeal. It held that obtaining a lawyer was not necessary: the applicant could reasonably visit the care fund and ask about the applicable legal rules, the reasons for the refusal, and the prospects of an objection. No costs decision was required.
BerHG § 1 Abs. 1 Nr. 2; necessity of legal assistance in challenging a care-insurance decision on classification at a care level. The need for a lawyer is assessed in light of whether the person seeking assistance can reasonably obtain information and advice by other means. In this context, it is generally reasonable to approach the care insurance fund directly to learn the legal basis and reasons for its decision and to ask about the prospects of an objection. The fact that the challenged decision concerns the assignment of a care level does not, by itself, make counsel necessary.
Entscheidungsdatum: 2006-06-01
Aktenzeichen: 46 UR II 22/06
ECLI: ECLI:DE:AGAC2:2006:0601.46UR.II22.06.00
Dokumenttyp: Beschluss
Spruchkörper: Abteilung 46
Normen: BerHG § 1 Abs. 1 Nr. 2; VwVfG § 25; SGB XI 7 Abs. 2
Auch bei ablehnenden Bescheiden der Pflegeversicherung wegen der Einstufung in eine Pflegestufe ist die Einschaltung eines Rechtsanwaltes im Wege der Beratungshilfe nicht notwendig, weil es für den Antragsteller grundsätzlich zumutbar ist, die Pflegekasse aufzusuchen und sich dort über die Rechtsgrundlagen, die Gründe der ablehnenden Entscheidung und die Erfolgsaussichten eines Widerspruchs beraten zu lassen.
Die Beschwerde vom 12.05.2006 gegen den Beschluss der Rechtspflegerin des Amtsgerichts Eschweiler vom 27.03.2006 wird zurück gewiesen.
Eine Kostenentscheidung ist nicht veranlasst.
Whether a lawyer was necessary for advice or assistance in challenging the care insurer’s refusal to assign a care level.
A lawyer was not necessary because the applicant could reasonably seek information and advice directly from the care insurance fund.
The applicant could visit the fund to learn the legal basis and reasons for the refusal and obtain advice on the prospects of an objection.
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