{"id":771633,"date":"2026-04-30T04:31:42","date_gmt":"2026-04-30T02:31:42","guid":{"rendered":"https:\/\/kohenavocats.com\/cour-dappel-de-caen-le-8-janvier-2026-n24-00378\/"},"modified":"2026-04-30T04:31:42","modified_gmt":"2026-04-30T02:31:42","slug":"cour-dappel-de-caen-le-8-janvier-2026-n24-00378","status":"publish","type":"post","link":"https:\/\/kohenavocats.com\/en\/cour-dappel-de-caen-le-8-janvier-2026-n24-00378\/","title":{"rendered":"Cour d’appel de Caen, le 8 janvier 2026, n\u00b024\/00378"},"content":{"rendered":"
\n

La cour d\u2019appel de Caen, dans son arr\u00eat du 8 janvier 2026, infirme le jugement du tribunal judiciaire de Coutances qui avait annul\u00e9 un avertissement notifi\u00e9 par une caisse primaire d\u2019assurance maladie \u00e0 une assur\u00e9e sociale pour poursuite d\u2019activit\u00e9 non autoris\u00e9e durant un arr\u00eat de travail. Une salari\u00e9e aide \u00e0 domicile, \u00e9galement auto-entrepreneuse en secr\u00e9tariat, per\u00e7oit des indemnit\u00e9s journali\u00e8res du 7 novembre 2018 au 11 novembre 2020. La caisse lui notifie un indu et un avertissement pour avoir exerc\u00e9 son activit\u00e9 ind\u00e9pendante sans autorisation m\u00e9dicale pr\u00e9alable. L\u2019assur\u00e9e conteste la sanction, invoquant l\u2019accord oral de son m\u00e9decin et sa bonne foi. La question de droit porte sur la condition d\u2019intention frauduleuse exig\u00e9e pour qualifier les faits de fraude et prononcer un avertissement.<\/p>\n

I. L\u2019absence d\u2019autorisation m\u00e9dicale pr\u00e9alable justifie la sanction<\/p>\n

L\u2019inobservation volontaire de l\u2019obligation de s\u2019abstenir de toute activit\u00e9 non autoris\u00e9e est \u00e9tablie par la seule poursuite d\u2019une activit\u00e9 r\u00e9mun\u00e9r\u00e9e. La cour rappelle que l\u2019assur\u00e9e ne pouvait exercer une activit\u00e9 sans autorisation expresse et pr\u00e9alable du m\u00e9decin prescripteur, conform\u00e9ment \u00e0 l\u2019article L323-6 du code de la s\u00e9curit\u00e9 sociale. Elle souligne que la charge de prouver cette autorisation incombe \u00e0 l\u2019assur\u00e9e. En l\u2019esp\u00e8ce, le courrier du m\u00e9decin, post\u00e9rieur aux arr\u00eats de travail, ne constitue pas une autorisation expresse et pr\u00e9alable. La cour \u00e9carte l\u2019argument tir\u00e9 d\u2019une case coch\u00e9e sur un formulaire, car les autres avis d\u2019arr\u00eat ne renseignaient pas cette rubrique. Cette solution affirme que la preuve d\u2019une autorisation m\u00e9dicale ne peut r\u00e9sulter d\u2019\u00e9l\u00e9ments post\u00e9rieurs ou ambigus. La port\u00e9e de ce raisonnement est de rappeler la rigueur formelle exig\u00e9e pour d\u00e9roger \u00e0 l\u2019interdiction l\u00e9gale d\u2019activit\u00e9 pendant un arr\u00eat de travail.<\/p>\n

II. L\u2019absence d\u2019intention frauduleuse n\u2019exclut pas la validit\u00e9 de l\u2019avertissement<\/p>\n

L\u2019avertissement peut \u00eatre prononc\u00e9 sans d\u00e9monstration d\u2019une intention frauduleuse, d\u00e8s lors que l\u2019inobservation des r\u00e8gles est \u00e9tablie. La cour distingue la qualification de fraude, pr\u00e9vue \u00e0 l\u2019article R147-11, de la proc\u00e9dure de sanction de l\u2019article L114-17-1. Elle indique que le directeur de la caisse peut notifier un avertissement m\u00eame en l\u2019absence de fraude caract\u00e9ris\u00e9e. Elle pr\u00e9cise que les observations de l\u2019assur\u00e9e, notamment sa pr\u00e9tendue bonne foi, ont \u00e9t\u00e9 prises en compte pour limiter la sanction \u00e0 un simple avertissement. La cour valide ainsi une sanction mesur\u00e9e et proportionn\u00e9e, fond\u00e9e sur le constat objectif de l\u2019activit\u00e9 non autoris\u00e9e. Cette d\u00e9cision a pour valeur de confirmer que la bonne foi de l\u2019assur\u00e9 n\u2019est pas une cause d\u2019exon\u00e9ration automatique, mais un \u00e9l\u00e9ment d\u2019appr\u00e9ciation de la proportionnalit\u00e9 de la sanction. La port\u00e9e est de s\u00e9curiser le pouvoir du directeur de la caisse de prononcer un avertissement sans exiger d\u2019intention frauduleuse.<\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

La cour d\u2019appel de Caen, dans son arr\u00eat du 8 janvier 2026, infirme le jugement du tribunal judiciaire de Coutances qui avait annul\u00e9 un avertissement notifi\u00e9 …<\/p>\n","protected":false},"author":232070755,"featured_media":4733,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_crdt_document":"","_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_kj_source_type":"judilibre","_kj_official_id":"696138e0cdc6046d47c430eb","_kj_official_url":"https:\/\/www.courdecassation.fr\/decision\/696138e0cdc6046d47c430eb","_kj_judilibre_id":"696138e0cdc6046d47c430eb","_kj_jur":"Cour d'appel","_kj_lieu":"Caen","_kj_chambre":"2\u00e8me chambre sociale","_kj_rg":"24\/00378","_kj_date":"2026-01-08","_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_post_was_ever_published":false},"categories":[7597],"tags":[],"class_list":["post-771633","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-jurisprudence"],"yoast_head":"\nCour d'appel de Caen, le 8 janvier 2026, n\u00b024\/00378 - 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