Pas de recours subrogatoire des tiers contre l’ONIAM

FlickR - paris 011 - TjeerdDans un avis du 22 janvier 2010, le Conseil d’État a affirmé qu’il n’existe pas au bénéfice du tiers-payeur de recours subrogatoire contre l’Office national des accidents médicaux, des affections iatrogènes et des infections nosocomiales (ONIAM). C’est une solution qui me paraît s’imposer avec la force de l’évidence dès lors que l’ONIAM a été créé par la loi du 4 mars 2002 pour désengorger les prétoires et offrir une solution rapide, efficace et peu coûteuse (entre l’apparence des textes et la réalité des pratiques, il y a parfois un fossé pour ne pas dire plus) au bénéfice des victimes, au titre de la solidarité nationale.

Or, le tiers-payeur est, par excellence, la caisse de sécurité sociale et, au premier chef, la caisse primaire d’assurance maladie (CPAM) – acteur encore trop souvent négligé dans les procès en responsabilité civile – qui n’a pas manqué de verser des prestations à la victime, également au titre de la solidarité nationale. L’article L.111-1 du code de la sécurité sociale proclame en effet solennellement en son alinéa 1er que « l’organisation de la sécurité sociale est fondée sur le principe de solidarité nationale ». Ce principe fait directement écho au troisième pilier de la devise républicaine : la fraternité. Mais là, je digresse.

Il en résulte que caisses de sécurité sociale et ONIAM obéissent à la même logique et, au demeurant, au même ministère de tutelle.

La haute assemblée a, par ailleurs, estimé que « la réparation qui incombe sous certaines conditions à l’ONIAM, en vertu des dispositions de l’article L. 1142-1 du code de la santé publique, a pour objet d’assurer, au titre de la solidarité nationale, la prise en charge des conséquences d’un accident médical, d’une affection ou d’une infection qui ne peuvent être imputées à la faute d’un professionnel, d’un établissement ou service de santé ou au défaut d’un produit de santé, sans que cet établissement public ait la qualité d’auteur responsable des dommages. Il en résulte que les recours subrogatoires des tiers-payeurs ayant versé des prestations à la victime d’un dommage corporel, organisés par l’article L. 376-1 du code de la sécurité sociale, l’article 1er de l’ordonnance n° 59-76 du 7 janvier 1959 et l’article 29 de la loi n° 85-677 du 5 juillet 1985, ne peuvent être exercés contre l’ONIAM lorsque celui-ci a pris en charge la réparation de ce dommage au titre de la solidarité nationale ».

Les juges du Palais-Royal indiquent aussi que le juge doit demander à la victime ou à ses ayants droit d’indiquer, « si ces informations ne ressortent pas des pièces du dossier, sa qualité d’assuré social ou d’agent public ainsi que la nature et le montant des prestations qu’elle a, le cas échéant, perçues d’un ou plusieurs des tiers-payeurs énumérés à l’article 29 de la loi du 5 juillet 1985. Il entre également dans l’office du juge, s’il l’estime utile pour le règlement du litige, de diligenter des mesures d’instruction auprès des tiers-payeurs. En revanche, il ne lui appartient pas d’appeler en la cause, par principe et sous peine d’irrégularité de sa décision, les tiers-payeurs dans un litige relatif à la réparation des préjudices par l’ONIAM au titre de la solidarité nationale ».

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