{"id":748358,"date":"2026-04-29T09:03:14","date_gmt":"2026-04-29T07:03:14","guid":{"rendered":"https:\/\/kohenavocats.com\/cour-dappel-de-toulouse-le-21-janvier-2026-n24-01385\/"},"modified":"2026-04-29T09:03:14","modified_gmt":"2026-04-29T07:03:14","slug":"cour-dappel-de-toulouse-le-21-janvier-2026-n24-01385","status":"publish","type":"post","link":"https:\/\/kohenavocats.com\/tr\/cour-dappel-de-toulouse-le-21-janvier-2026-n24-01385\/","title":{"rendered":"Cour d’appel de Toulouse, le 21 janvier 2026, n\u00b024\/01385"},"content":{"rendered":"
\n

La cour d’appel de Toulouse, dans son arr\u00eat du 21 janvier 2026, statuait sur renvoi apr\u00e8s cassation partielle d’un pr\u00e9c\u00e9dent arr\u00eat. La caisse primaire d’assurance maladie contestait le montant allou\u00e9 pour ses d\u00e9penses de sant\u00e9 futures.<\/p>\n

Le litige portait sur l’\u00e9valuation forfaitaire des d\u00e9penses de sant\u00e9 futures selon l’arr\u00eat\u00e9 du 27 d\u00e9cembre 2011. L’assureur du m\u00e9decin soutenait que ce calcul devait \u00eatre r\u00e9duit pour tenir compte d’un renouvellement biannuel des appareillages.<\/p>\n

I. L’application stricte du bar\u00e8me forfaitaire<\/p>\n

La cour rappelle que le juge, lorsqu’il choisit d’appliquer l’arr\u00eat\u00e9, doit en respecter toutes les dispositions. “Si les modalit\u00e9s fix\u00e9es par cet arr\u00eat\u00e9 ne s’imposent pas au juge, qui reste libre de se r\u00e9f\u00e9rer au bar\u00e8me qu’il estime le plus ad\u00e9quat, il doit, lorsqu’il d\u00e9cide d’appliquer cet arr\u00eat\u00e9, en respecter les dispositions”<\/em> (Motifs, citant l’arr\u00eat de cassation).<\/p>\n

L’arr\u00eat\u00e9 pr\u00e9voit un calcul de l’annuit\u00e9 \u00e0 partir d’un pourcentage et d’une base, sans division pour fr\u00e9quence de renouvellement. La caisse a donc correctement appliqu\u00e9 le bar\u00e8me en retenant un renouvellement annuel pour les chaussures orthop\u00e9diques.<\/p>\n

La cour \u00e9carte l’argument du m\u00e9decin qui proposait un am\u00e9nagement du calcul forfaitaire. Elle souligne que l’expert avait seulement pr\u00e9vu un renouvellement biannuel pour les semelles, et que le taux de 50% appliqu\u00e9 \u00e0 ces derni\u00e8res prenait d\u00e9j\u00e0 en compte cette fr\u00e9quence.<\/p>\n

II. L’absence de preuve d’une \u00e9valuation plus ad\u00e9quate<\/p>\n

Le m\u00e9decin, qui ne propose aucun calcul alternatif, \u00e9choue \u00e0 d\u00e9montrer qu’une autre m\u00e9thode assurerait une r\u00e9paration int\u00e9grale. “M.[H], qui ne propose pas de calcul alternatif, mais seulement un am\u00e9nagement du calcul forfaitaire r\u00e9sultant de l’arr\u00eat\u00e9, ne justifie pas d’une \u00e9valuation plus apte \u00e0 assurer une r\u00e9paration int\u00e9grale”<\/em> (Motifs).<\/p>\n

La cour rel\u00e8ve que le rapport d’expertise, non vers\u00e9 aux d\u00e9bats, ne permet pas d’\u00e9tablir que les chaussures orthop\u00e9diques devaient \u00eatre renouvel\u00e9es tous les deux ans. Cette absence de preuve renforce la solution retenue par la cour.<\/p>\n

La port\u00e9e de cet arr\u00eat est de rappeler le caract\u00e8re contraignant du bar\u00e8me forfaitaire pour le juge qui l’adopte. La valeur de la d\u00e9cision est de pr\u00e9ciser que la charge de la preuve d’une \u00e9valuation plus ad\u00e9quate incombe \u00e0 celui qui conteste le calcul forfaitaire.<\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

La cour d’appel de Toulouse, dans son arr\u00eat du 21 janvier 2026, statuait sur renvoi apr\u00e8s cassation partielle d’un pr\u00e9c\u00e9dent arr\u00eat. La caisse primaire…<\/p>\n","protected":false},"author":232070755,"featured_media":9467,"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":"6971c6f7cdc6046d473454c0","_kj_official_url":"https:\/\/www.courdecassation.fr\/decision\/6971c6f7cdc6046d473454c0","_kj_judilibre_id":"6971c6f7cdc6046d473454c0","_kj_jur":"Cour d'appel","_kj_lieu":"Toulouse","_kj_chambre":"1ere Chambre Section 1","_kj_rg":"24\/01385","_kj_date":"2026-01-21","_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_post_was_ever_published":false},"categories":[6455,6454],"tags":[],"class_list":["post-748358","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-cour-dappel","category-decisions-juridiques"],"yoast_head":"\nCour d'appel de Toulouse, le 21 janvier 2026, n\u00b024\/01385 - Ma\u00eetre Hassan Kohen, avocat en droit p\u00e9nal \u00e0 Paris<\/title>\n<meta name=\"description\" content=\"La cour d'appel de Toulouse, dans son arr\u00eat du 21 janvier 2026, statuait sur renvoi apr\u00e8s cassation partielle d'un pr\u00e9c\u00e9dent arr\u00eat. 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