Judgment No. 992
THE COMPLAINT IS DISMISSED.
The complainant's application for permission to take a cure prescribed by his doctor was rejected. The Agency's medical officer reported to the health fund that the doctor had given no clear evidence of the need for the prescribed treatment. In keeping with Article 20 of Rule No. 10 concerning sickness and accident insurance, expenses relating to a cure shall be refunded provided that the cure "is recognised as strictly necessary by the medical officer". The Tribunal sees nothing improper in the medical officer's assessment nor in the administration's ensuing denial of permission.
cure; medical consultant; medical opinion; refund; refusal; medical expenses; health insurance