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Ambrumenil and Another v Commissioners of Customs and Excise, Court of Justice of the European Communities, 20 November 2003

1 December 2003
The issues

VAT – expert reports – medical experts – exemption.

The facts

The Claimant Peter d’Ambrumenil was an expert medical witness in cases involving personal injury and medical negligence and also disciplinary proceedings. The Second Claimant, Dispute Resolution Services Limited was a Company formed by Mr D’Ambrumenil for the purposes of applying medico-legal expertise. The Customs and Excise took the view that the services provided were not exempt from VAT. The Claimant appealed and the VAT Tribunal sought a preliminary ruling on whether activities of the sort carried on by Peter d’Ambrumenil came within Article 13(A)(i)(c) of the Sixth Directive and were therefore exempt. Article 13(A)(i) purported to exempt from VAT “a provision of medical care and the exercise of the medical and paramedical professions as defined by the Member State concerned”.

The decision

1. Exemption was governed and determined by the purpose the medical service provided.

2. If the principle purpose was the protection of health, including the maintenance or restoration of human health, the exemption applied.

3. If the principle purpose was the provision of advice required for a decision in legal proceedings or to enable a third party to make a decision with legal consequences for the person in question, the exemption did not apply.

4. Regular medical checks at the request of an employer or an insurance company could satisfy the conditions for exemption if they were intended principally to enable the prevention or detection of illness or the monitoring of the health of workers or insured individuals.

5. Thus the provision applied to medical services consisting of:-

(i) Conducting medical examinations of individuals for employers or insurance companies;

(ii) The taking of blood or other bodily samples to test for the present of viruses, infections or other diseases on behalf of employers or insurers;

(iii) Certifications of medical fitness, eg fitness to travel, where those services were intended principally to protect the health of the person concerned.

6. The exemption did not apply to the following services:-

(i) Giving certificates as to a person’s medical condition for purposes such as entitlement to pension;

(ii) Medical examinations conducted for the purpose of preparing an expert medical report, regarding either issues of liability or quantum in personal injury litigation;

(iii) Preparation of the medical reports referred to above and to include medical reports prepared without conducting a medical examination;

(iv) Medical examinations prepared in the context of medical negligence litigation, to include reports prepared without an examination of an individual.

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