natgillin/translations-raw huggingface dataset:
It is then for the Court to ascertain whether, in this case, the Commission’s assessment on those points is well founded by reference to current conditions and probable developments in the Irish PMI market as they appeared at the time of adoption of the contested decision in the light of all the information which the Commission had, or ought reasonably to have had, at its disposal.
Seejärel peab Esimese Astme Kohus kontrollima, kas käesolevas asjas on komisjoni analüüs nende kahe punkti kohta põhjendatud, arvestades Iirimaa ERK turu hetketingimusi ja tõenäolist arengut, nagu need ilmnevad vaidlustatud otsuse vastuvõtmise hetkel, arvestades kõiki andmeid, mis komisjonil oli või mis tal mõistlikult oleks pidanud olema.
As regards, in particular, the extent of the Commission’s review, in accordance with what is set out at paragraphs 220 to 222 above, the Commission cannot take the
Mis puudutab eeskätt komisjoni kontrolli ulatust, vastavalt eespool punktides 220–222 sätestatule, ei saaks ta võtta liikmesriigi rolli viimasele omase laia
Thus, contrary to what the applicants appear to suggest, in assessing whether the measure in question is necessary, the Commission has no power to ascertain, on the basis of the available data, whether the market might actually develop in a certain way and whether the application of the regulatory instruments envisaged by the notified system will thereby become indispensable, at a given moment, to ensure the achievement of the SGEI mission in question.
Seega, vastupidi sellele, mida hagejad näivad väitvat, ei ole komisjonil vajalikkuse kontekstis õigus olemasolevate andmete alusel kontrollida, kas esiteks võib turg tegelikult ka teatavas suunas areneda ja kas teiseks muutub teatatud süsteemiga ette nähtud reguleerimisinstrumentide kohaldamine teatud kindlal hetkel hädavajalikuks asjaomase ÜMPT ülesande täitmise tagamiseks.
In effect, the review of necessity does not require that the Commission be convinced that the Member State, in the light of present or future market conditions, cannot abandon the notified measures, but is limited to ascertaining whether there has been a manifest error in the exercise of the wide discretion of the Member State as regards the way of ensuring that the SGEI mission may be achieved under economically acceptable conditions (see, to that effect, Commission v Netherlands, paragraph 99 above, paragraph 58, and Albany, paragraph 101 above, paragraphs 107 and 111).
Tegelikult ei nõua vajalikkuse kontroll, et komisjon jõuaks veendumusele, et liikmesriik ei või turu praeguseid või tulevasi tingimusi silmas pidades loobuda teatatud meetmetest, vaid ta peab üksnes kontrollima ilmse vea olemasolu liikmesriigi laia kaalutlusõiguse kasutamisel seoses viisiga, kuidas tagada ÜMPT ülesande täitmine majanduslikult vastuvõetavates tingimustes (vt selle kohta eespool punktis 99 viidatud kohtuotsus komisjon vs. Madalmaad, punkt 58 ja eespool punktis 101 viidatud Albany kohtuotsus, punkt 107 ja 111).
That review by the Court must be even more restricted because the Commission’s assessment relates to complex economic facts (see paragraphs 220 and 221 above).
See Esimese Astme Kohtu kontroll on seda piiratum, kui komisjoni hinnang käsitleb keerulisi majandusnäitajaid (vt eespool punktid 220 ja 221).
In effect, such review by the Court must be limited to determining whether those measures are manifestly inappropriate by reference to the objective pursued (see, by analogy, Boehringer v Council and Commission, paragraph 118 above, paragraphs 73 and 74).
Tegelikult peab Esimese Astme Kohtu kontroll piirduma kontrolliga, kas need meetmed on ilmselgelt sobimatud taotletud eesmärgiga võrreldes (vt analoogia alusel eespool punktis 118 viidatud kohtuotsus Boehringer vs. nõukogu ja komisjon, punktid 73 ja 74).
It follows from the foregoing that the Commission did not make a manifest error of assessment by not requiring that Ireland demonstrate that the RES was indispensable in order to ensure compliance with the PMI obligations.
Eelnevast tuleneb, et komisjon ei teinud ilmset hindamisviga, kui ta ei nõudnud Iirimaalt tõendust RES-i hädavajalikkuse kohta, et tagada ERK kohustuste täitmine.
The Court must therefore reject the applicants’ argument that the RES must be indispensable and that the Commission misunderstood the scope of the review which it must carry out in that regard.
Järelikult tuleb tagasi lükata hagejate argument, mille kohaselt RES peab olema hädavajalik ja komisjon on rikkunud tema poolt teostatava kontrolli ulatust sellega seoses.
(3) The presence of risk selection on the Irish PMI market
3) Iirimaa ERK turul riskide valiku olemasolu
In the light of the foregoing, the Court must examine — first of all from a general viewpoint and then by reference to the particular conditions on the Irish PMI market — whether the Commission was entitled to consider that the RES constituted a necessary corrective in a PMI market subject to obligations of open enrolment, community rating, lifetime cover and minimum benefits.
Eelneva valguses tuleb uurida – esiteks üldisest vaatepunktist ja seejärel Iirimaa ERK turu konkreetseid tingimusi arvestades –, kas komisjon võis õigustatult järeldada, et RES oli vajalik parandusmeede ERK turul, kus kehtisid avatud liitumise, ühtsete hindade, eluaegse kaitse ja miinimumhüvitiste kohustused.
In that regard, it is appropriate to ascertain in particular whether the Commission relied on evidence which enabled it to demonstrate to the requisite standard that a PMI market with community rating was in danger of risk selection and whether it could reasonably consider that that situation might upset the balance of that market.
Sellega seoses tuleb kontrollida eeskätt, kas komisjon tugines sellistele asjaoludele, mis võimaldavad piisavalt tõendada, et ühtsete hindadega ERK turul valitses riskide valiku oht, ja kas ta võis mõistlikult järeldada, et see olukord võib nimetatud turu tasakaalust välja viia.
Active risk selection
Riskide aktiivne valik
— General economic premisses
– Üldised majanduslikud eeldused
As regards the existence of a danger of active risk selection, the parties are agreed that a new entrant on to the PMI market, such as BUPA Ireland in 1997, has an interest in seeking a low-risk customer base in order to minimise its economic risks and to reinforce what is still a fragile position on the market.
Mis puudutab riskide aktiivse valiku ohtu, siis ei ole poolte vahel vaidlust selles, et ERK turule uuel sisenejal – nagu BUPA Irelandil 1997. aastal – on huvi otsida väiksema riskiga kliente, et vähendada majandusriske ja tugevdada oma seni veel õrna seisundit turul.
That is particularly so in the case of a market whose competitive structure still shows significant traces of the situation preceding its liberalisation and of a certain inertia on the part of consumers, the majority of whom are affiliated to the former monopoly operator, such as the
See on nii eeskätt siis, kui sellel turul valitseb liberaliseerimisele eelnenud aega tugevalt iseloomustav konkurentsistruktuur ja tarbijate teatav inertsus, kellest suurem osa on liitunud varasema monopoolse ettevõtjaga, nagu käesolevas asjas VHI. Nagu hagejad isegi märgivad, on neis tingimustes noor ja hea
VHI in this case. As the applicants themselves observe, young, healthy customers, in particular, constitute a significant group of new customers that is particularly likely to be targeted by a new entrant to the PMI market offering them lower rates than those offered by the other PMI insurers.
KOMISJON tervisega klientuur nimelt oluline grupp uutest klientidest, kellele ERK turule uus siseneja eriti võib keskenduda, pakkudes neile madalamaid hindasid kui teised ERK kindlustusandjad.
In that regard, the applicants have not disputed, with sufficient accuracy and in sufficient detail, the theory that that tendency to seek lower risks is reinforced by the community rating obligation.
Sellega seoses ei vaidlustanud hagejad piisavalt täpselt ja üksikasjalikult väidet, mille kohaselt ühtsete hindade kohustus tugevdab seda tendentsi otsida madalamaid riske.
It is common ground that, because of that obligation, a PMI insurer is not entirely free to balance, by charging of higher premiums, the greater economic risk in providing PMI cover to an elderly or sick person whom the insurer cannot refuse owing to the open enrolment obligation.
Vaidlust ei ole selles, et nimetatud kohustuse alusel ei ole ERK kindlustusandja täiesti vaba tasakaalustama kõrgemate kindlustusmaksetega suuremat majandusriski, mille toob kaasa vanema või haige isiku ERK kindlustuskaitse, kelle kindlustamisest see kindlustusandja avatud liitumise kohustuse tõttu keelduda ei saa.
First, as the PMI insurer is unable to set its premiums on the basis of the risk insured, it is required to offer the same PMI cover, on the same conditions as regards rates, to all insured persons, independently of their age, sex and state of health (section 7 of the Health Insurance Act, 1994, as amended) and thus to cross-subsidise premiums between the different risks insured.
Esiteks, kuna puudub võimalus kindlustatud riskile tuginevaid hindasid kehtestada, siis on ERK kindlustusandja kohustatud pakkuma sama ERK kindlustuskaitset samadel tingimustel kõigile kindlustatutele, sõltumata nende vanusest, soost ja tervislikust seisundist (1997 Health Insurance Act (muudetud kujul), artikkel 7), ja peab seega teostama erinevate kindlustatud riskide kindlustusmaksete vahelist risttoetust.
Second, the PMI insurer is also unable to offer PMI cover at premiums fixed according to the highest risk that it is required to cover, as otherwise it will no longer be capable of attracting young, healthy customers, when they are essential for its economic equilibrium in a system of cross-subsidised premiums.
Teiseks ei saa ERK kindlustusandja pakkuda ka kindlate kindlustusmaksetega ERK kindlustuskaitseid vastavalt kõige kõrgemale riskile, mida ta kandma peab, kuna siis ei oleks ta enam suuteline ahvatlema noori ja hea tervisega kliente, kuigi need on esmase tähtsusega tema majanduslikule tasakaalule kindlustusmaksete risttoetuste süsteemis.
The applicants have not relied on any specific evidence capable of invalidating that description of the phenomenon of active risk selection in a PMI market with community rating.
Hagejad ei viidanud konkreetsetele asjaoludele, mis võiksid kõigutada seda kirjeldust ühtsete hindadega ERK turul toimuvast riskide aktiivse valiku nähtusest.
In that regard, the applicants essentially confined themselves to invoking the possibility for PMI insurers to segment the market according to risk by defining the terms of PMI insurance and fixing the amount of the premiums in order to be able to offset the ‘bad’ risks by higher premiums.
Sellega seoses piirdusid hagejad sisuliselt viitega sellele, et ERK kindlustusandjad võivad turgu jagada riski alusel, määratledes ERK kindlustuskaitsete sisu ja kehtestades kindlustusmaksete summad, et kõrgemate kindlustusmaksetega „halbasid” riske kompenseerida.
However, it must be borne in mind that, for the reasons set out at paragraphs 229 and 231 above, the argument relating to the contractual freedom of PMI insurers cannot be upheld.
Tuleb meenutada, et eespool punktides 229 ja 231 esitatud põhjustel ei saa nõustuda argumendiga ERK kindlustusandjate lepinguvabaduse kohta.
Furthermore, the Court considers that, on the contrary, that argument tends rather to confirm the existence of an increased risk of the selection of ‘good’ risks in a PMI market with community rating, in that it implies that, in practice, PMI insurers will seek to offset, by lawful means, the effects of the prohibition on risk-based rating by offering a specially-defined definition of PMI cover and fixing the corresponding premiums according to the needs of distinct groups of insured persons.
Lisaks leiab Esimese Astme Kohus, et see argument pigem hoopis kinnitab „heade” riskide valimise suurenenud ohtu ühtsete hindadega ERK turul, mis tähendab, et praktikas soovivad ERK kindlustusandjad seaduslike vahenditega kompenseerida mõjusid, mida tekitab keeld kehtestada hinnad lähtuvalt kindlustatud riskist, määratledes konkreetselt ERK kindlustuskaitse ja kehtestades vastavad kindlustusmaksed vastavalt erinevate kindlustatute gruppide vajadustele.
In effect, the applicants claim that a PMI insurer may attract young ‘good risk’ customers by providing cover specially adapted to their needs, at attractive premiums, with the corollary that other groups of insured persons, the ‘bad risk’ customers, have no incentive to subscribe to such unsuitable cover, and are even deterred from doing so.
Tegelikult väidavad hagejad, et ERK kindlustusandja võib ahvatleda noori ja „hea riskiga” kliente nimelt nende vajadustele kohandatud ja soodsate kindlustusmaksetega kindlustuskaitsega, mistõttu teisi kindlustatute gruppe, sh „halva riskiga” kindlustatuid, ei ärgitata liituma neile sobimatu kindlustuskaitsega või lausa pärsitakse nende tahet seda teha.
Irrespective of whether such a strategy of indirect discrimination between insured persons — a point not addressed by community rating, which prohibits only direct price discrimination — is practicable, which Ireland, in particular, denies, that strategy seems to be all the more plausible when competition between PMI insurers is particularly strong for the new, youngest, customers, as is the case here, as the parties are agreed in their submissions, between BUPA Ireland and the VHI.
Sõltumata küsimusest, kas selline kindlustatute kaudne diskrimineerimine – mida ühtsete hindade kohustus, mille alusel on keelatud üksnes otsene hinnadiskrimineerimine, ei puuduta – on praktiline (Iirimaa vaidleb aga sellele vastu), on see strateegia seda usutavam, kui konkurents ERK kindlustusandjate vahel on eriti tugev uute kõige nooremate klientide osas, nagu vastavalt poolte kokkulangevatele ütlustele käesolevas asjas toimus BUPA Irelandi ja VHI vahel.
However, in those circumstances, contrary to the applicants’ opinion, that strategy does not contradict the existence of the phenomenon of active risk selection, but tends rather to confirm it, indeed to exacerbate it.
Siiski ei lükka vastupidi hagejate arvamusele see strateegia ümber riskide aktiivse valiku nähtuse olemasolu, vaid pigem kinnitab või lausa võimendab seda.
Accordingly, the applicants’ argument based on the contractual freedom of PMI insurers is not capable of demonstrating the absence of active risk selection.
Seega ei ole hagejate argument ERK kindlustusandjate lepinguvabaduse kohta riskide aktiivse valiku puudumise tõendamisel tulemuslik.
Consequently, there is no manifest error of assessment in the Commission’s finding, at recital 50 to the contested decision, concerning the danger of active risk selection, that PMI insurers could seek to achieve a better risk profile by, for example, selective marketing techniques, benefit design or selective quality of service.
Järelikult ei teinud komisjon ilmset viga oma järelduses vaidlustatud otsuse punktis 50 riskide aktiivse valiku ohu olemasolust, mille kohaselt ERK kindlustusandjad võisid üritada oma keskmist riskiprofiili parandada eeskätt valikuliste turundusstrateegiatega, kindlustuskaitsete sisu määratlemisega või teenuste kvaliteedi eristamisega.
In that regard, the Court considers that the theory that a danger of active risk selection and, accordingly, a risk of market instability is real and strong when the PMI insurer with a favourable risk profile embarks upon a strategy of price ‘predation’, as described at paragraph 6 of the RES guide, is plausible.
Sellega seoses loeb Esimese Astme Kohus usutavaks oletuse, et riskide aktiivse valiku oht ja seega turu ebastabiilsuse oht on tegelik ja suur, kui soodsa riskiprofiiliga ERK kindlustusandja harrastab „turuhinnast madalama” hinna strateegiat, nagu on kirjeldatud RES juhiste punktis 6.
On the other hand, that danger appears to be less strong, but still sufficiently significant, when that insurer adopts — as the defendant, Ireland and the VHI claim with respect to BUPA Ireland’s conduct — a ‘price follower’ strategy, consisting in fixing the rates for its own PMI services at just below the rates charged by its main competitors for the same services.
Seevastu näib see oht olevat nõrgem, kuid siiski piisavalt tuntav, kui see kindlustusandja harrastab hindade „järgimise” strateegiat – mida vastavalt kostja, Iirimaa ja VHI väidetele oli teinud BUPA Ireland –, kus kindlustusandja ERK teenuste hinnad kehtestatakse üksnes pisut madalamal tasemel kui konkurentide hinnad samade teenuste eest.
In those circumstances, the customer would appear to have less financial incentive
Neis tingimustes näib kliendi rahaline ajend vahetada ERK kindlustusandjat olevat tunduvalt väiksem kui „turuhinnast
However, in that regard, the defendant and Ireland assert, without being contradicted by the applicants, that such a strategy none the less allows an insurer to select the ‘good’ risks and that, especially, it affects the proper functioning of the PMI market and runs counter to the objective of community rating by maintaining premiums that are too high, to the detriment of customers, by comparison with the costs of claims which a PMI insurer with a favourable risk profile must actually bear.
Siiski väidavad kostja ja Iirimaa, ilma et hagejad neile vastu vaidleks, et selline strateegia võimaldab siiski valida „häid” riske ja et eeskätt mõjutab see ERK turu nõuetekohast toimimist ning läheb vastuollu ühtsete hindade eesmärgiga, kuna kindlustusmaksed hoitakse kindlustatuid kahjustades liiga kõrgel, võrreldes soodsa riskiprofiiliga ERK kindlustusandja klientidele hüvitatavad kuludega, mida ta tegelikult peab kandma.
It also seems plausible that the ‘price follower’ strategy will have the effect that, notwithstanding its lower costs, the PMI insurer will decline to reduce its premiums, which would none the less be in the interest of consumers and consistent with the objective of community rating, with the sole aim of increasing its profits.
On samuti usutav, et hindade „järgimise” strateegia tagajärjel loobub ERK kindlustusandja pelgalt kasumi suurendamise eesmärgil ja vaatamata madalamatele kuludele vähendamast kindlustusmaksete summat, mis oleks siiski kindlustatute huvides ja kooskõlas ühtsete hindade eesmärgiga.
Likewise, it does not appear to be precluded that a PMI insurer with an advantageous risk profile will pursue active risk selection by adopting the ‘price follower’ strategy so long as the price differential is sufficiently large to attract ‘good risk’ consumers.
Samuti ei näi olevat välistatud, et soodsa riskiprofiiliga ERK kindlustusandja valiks aktiivselt riske hindade „järgimise” strateegiat kasutades, kui hinnaerinevus on piisavalt suur, et ahvatleda „hea riskiga” kliente.
The Court considers that both Ireland and the Commission, at recital 50 to the contested decision, submitted plausibly that such a commercial practice was likely to create a downward spiral and thus to destabilise the equilibrium and the functioning of the community rating PMI market in so far as PMI insurers with a favourable risk profile would be increasingly able to attract young, healthy customers and thus further improve their risk profile, whereas PMI insurers with an unfavourable risk profile would come under growing financial pressure owing to the increasing disequilibrium between premiums and the costs occasioned by the claims submitted by a large number of elderly insured persons in poor health.
Esimese Astme Kohus leiab, et nii Iirimaa kui ka komisjon märkisid vaidlustatud otsuse punktis 50 usutavalt, et selline kaubanduspraktika võis tekitada nõiaspiraali ja destabiliseerida sel moel ühtsete hindadega ERK turu tasakaalu ja toimimist, kuna soodsama riskiprofiiliga kindlustusandjad suudavad ahvatleda üha rohkem noori ja hea tervisega kliente oma riskiprofiili täiendavaks parandamiseks, samas kui ebasoodsa riskiprofiiliga ERK kindlustusandjatel on üha rohkem finantssurvet, kuna kindlustusmaksete ning suure hulga vanade ja halva tervisega kindlustatute hüvitistaotlustega tekitatud kulude vaheline tasakaalutus kasvab.
In those circumstances, the Court considers that there is no manifest error affecting the consideration, in recital 50 to the contested decision, that in a PMI market subject to community rating, open enrolment and lifetime cover, there is, in the absence of a
Neis tingimustes leiab Esimese Astme Kohus, et vaidlustatud otsuse punktis 50, mille kohaselt ERK turul, mis on allutatud ühtsete hindade, avatud liitumise ja eluaegse kindlustuskaitse kohustustele ja kus puudub riskide tasakaalustamise mehhanism,
— The situation on the Irish PMI market
– Iirimaa ERK turu olukord
The Court observes that the Commission found, at recital 51 to the contested decision, that on the Irish PMI market a danger of risk selection could not be ruled out even though no instability had yet been observed on that market.
Esimese Astme Kohus meenutab, et komisjon tuvastas vaidlustatud otsuse punktis 51, et Iirimaa ERK turul ei saa välistada riskide aktiivse valiku ohtu, kuigi turu ebastabiilsust veel ei täheldatud.
In that regard, it must be emphasised that, at the time of the adoption of the contested decision, BUPA Ireland had a distinctly more favourable risk profile than that of the VHI, its main competitor.
Sellega seoses tuleb sedastada, et vaidlustatud otsuse tegemise ajal oli BUPA Irelandil tunduvalt soodsam riskiprofiil kui tema peamisel konkurendil VHI-l.
Without there being any need to rule on the disputed issue of whether or not the VHI’s solvency ratios are satisfactory, it must be observed that the applicants have not really disputed the accuracy and the relevance of the data supplied by the defendant, by Ireland and by the VHI concerning the economic situation, the VHI’s risk profile and its higher average payment costs per insured person. They accepted that the VHI had a less healthy risk profile than BUPA Ireland (see paragraphs 135 and 138 above).
Ilma et oleks vaja seisukohta võtta vaidlusaluses küsimuses, kas VHI maksejõulisuse näitajad on rahuldavad või mitte, tuleb märkida, et hagejad ei vaielnud tegelikult vastu kostja, Iirimaa ja VHI esitatud andmete täpsusele ja asjakohasusele seoses VHI majandusliku olukorra, riskiprofiili ja kindlustatu kohta kõrgemate hüvitatud kuludega, vaid tunnistasid, et VHI-l on halvem riskiprofiil kui BUPA Irelandil (vt eespool punktid 135 ja 138).
Furthermore, in support of its assessment relating to the existence of a danger of active risk selection, the Commission relied on evidence showing that BUPA Ireland had in fact adopted a strategy of active risk selection combined with a ‘price follower’ strategy by offering rates that were in part significantly below those offered by the VHI to groups of consumers aged under 19 (with a price differential of 10%) and between the ages of 19 and 54 (with a price differential of 4%), whereas it required
Lisaks tugines komisjon oma hinnangus riskide aktiivse valiku ohu kohta tõenditele, mis näitavad, et BUPA Ireland rakendas tegelikult riskide aktiivse valiku strateegiat koostoimes hindade „järgimise” strateegiaga, kui ta pakkus osaliselt oluliselt madalamaid hindasid kui VHI tarbijate gruppidele, kes olid nooremad kui 19-aastased (hinnaerinevus oli 10%) ja vanuses 19–54 aastat (hinnaerinevus oli 4%), samas kui ta võttis (20%) kõrgemaid kindlustusmakseid vanematelt kui 54-aastastelt isikutelt
BUPA AND OTHERS v COMMISSION higher premiums (20% higher) from persons over the age of 54 (recital 51 and footnote 9 to the contested decision).
(vaidlustatud otsuse punkt 51 ja 9. joonealune märkus).
It should be emphasised that the applicants declined during the proceedings, including at the hearing, to comment on that evidence, notwithstanding the fact that both Ireland and the VHI relied expressly in their written submissions on BUPA Ireland’s alleged ‘price follower’ practice.
Tuleb rõhutada, et hagejad ei võtnud menetluse ja sh kohtuistungi käigus seisukohta nende tõendite osas, kuigi nii kostja kui ka Iirimaa ja VHI tuginesid oma kirjalikes avaldustes otsesõnu BUPA Irelandi väidetavale hindade „järgimise” praktikale.