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Article 5.1 Interruption of protection or service 1. Subject to the rovisions of this article, readmission of an insured person to the Fund after any interruption of the period of protection shall be treated as a first admission. 2. The following periods shall not be regarded as interrupting continuity of protection (a) any period during which the protected person was protected by a scheme of another international organization pursuant to the proviso to article 1.2, paragraph 2, or by reason of the secondment of an insured person to that organization; (b) any period during which an insured
person was on leave without salary or with partial salary but did not voluntarily
continue insurance pursuant to article 1.3(a):
3. A break of not more than 60 days in the period of protection by the Fund, in a period during which the person concerned was subject to another form of health protection referred to in article 1.3 or 2.3, in a period of service referred to in article 1.2, or between any such periods, shall not be regarded as interrupting their continuity: Provided that: (a) first admission of an insured person under article 1.2 shall be subject to the condition that the aggregate period of the latest appointment or extension of appointment and of earlier appointments in the ILO or ITU shall not be less than 180 days within a period of nine months; (b) benefits shall in no case be payable in respect of items of expenditure insured during any break in protection. 4. Without prejudice to the provisions
of paragraph 3, a person who within a period of not more than 12 months
from ceasing to be protected by the Fund again becomes a protected person
shall be treated as having completed on the date on which such new protection
takes effect any qualifying period for entitlement to benefits provided
for in these Regulations if he/she had been a protected person for at least
12 months immediately prior to the interruption of protection.
1. The Management Committee may prescribe the use of such forms as appear to it from time to time necessary for the proper administration of the Fund. 2. Insured persons shall comply with the
requirements as prescribed.
1. The Management Committee shall, in principle, accept the conclusions of the medical practitioner in attendance. It shall have the right, however, to have the patient re-examined by the Medical Adviser or a medical practitioner appointed by it, whenever this appears necessary and after notifying the medical practitioner in attendance. 2. If the conclusions of the medical practitioner in attendance and those resulting from the re-examination differ, or if an insured person contests other conclusions of the Medical Adviser, the insured person concerned may require that the case shall be considered by a committee composed of a medical practitioner designated by him/her, of the Medical Adviser and of a third medical practitioner designated by the first two. The parties shall be bound by the conclusions of this committee. Payments of the fees of the third medical practitioner shall be equally divided between the insured person and the Fund. 3. In cases other than those required to be submitted to the committee specified in paragraph 2, an insured person may require a decision of the Management Committee concerning the application to him/her of these Regulations to be referred to an Appeals Board composed of five members of the staff of the ILO or of ITU, namely (a) two persons chosen by the Management Committee from persons who are not members of that Committee; (b) two persons designated by the insured person concerned; (c) a Chairperson chosen by the above four persons or, in case of disagreement, by the Director-General of the ILO and the Secretary-General of the ITU. The Appeals Board shall, in its decisions,
apply these Regulations
These Regulations came into force on 1 April 1969. All amendments adopted up to 31 January 2000 in accordance with article 4.17 are incorporated in this reprint. |
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