Judgment No. 3354
Decision
1. The decision of the President of the Office of 11 November 2009 is set aside and the case is remitted to the EPO for a redetermination as detailed under 9 of Judgment 3158.
2. The EPO shall pay the complainant moral damages in the amount of 700 euros.
3. It shall also pay him 600 euros in costs.
4. All other claims are dismissed.
Summary
The Tribunal set aside the decision dismissing the complainant’s request for the reimbursement of pharmaceutical costs on the ground that the case should have been referred to the Medical Committee.
Judgment keywords
Keywords
complaint allowed; decision quashed; case sent back to organisation; medical expenses; health insurance
Consideration 5
Extract:
"A hearing of any internal appeal body provides an opportunity for the parties to articulate more fully their case and to answer questions from the members of the appeal body."
Keywords
internal appeals body; internal appeal
Consideration 10
Extract:
"[T]he President should not have, as she did in the impugned decision, dismissed out of hand the complainant’s appeal against the rejection of his claim for reimbursement for the product and the treatment. The matter should have been considered by the Medical Committee before such action was taken, if it accorded with the opinion of the Medical Committee. Accordingly, the impugned decision is flawed and should be set aside."
Keywords
medical opinion; refund
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