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Medical expenses (678,-666)

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Keywords: Medical expenses
Total judgments found: 50

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  • Judgment 924


    65th Session, 1988
    European Organisation for the Safety of Air Navigation
    Extracts: EN, FR
    Full Judgment Text: EN, FR

    Considerations 18-19

    Extract:

    The Eurocontrol Health Insurance Scheme in Luxembourg denied the complainant reimbursement of medical expenses incurred in Belgium by his wife who is entitled to so-called "supplementary coverage". The Tribunal holds that "since it has a duty to provide supplementary coverage the organisation was bound, under its own rules, to refund the full cost of Mrs. Boland's treatment in Belgium. The implied final decision must therefore be set aside and the case sent back to Eurocontrol for a new decision on the refund of the costs incurred by Mrs. Boland, with due regard to the freedom of choice guaranteed in Rule No. 10."

    Keywords:

    dependant; freedom to choose practitioner; health insurance; insurance; medical expenses; supplementary coverage;



  • Judgment 923


    65th Session, 1988
    European Organisation for the Safety of Air Navigation
    Extracts: EN, FR
    Full Judgment Text: EN, FR

    Consideration 12

    Extract:

    "In case of doubt it is for the staff member to show exactly what the treatment was if he is contending that the maximum limit does not apply."

    Keywords:

    burden of proof; disclosure of evidence; evidence; health insurance; maximum limit; medical expenses; request by a party;



  • Judgment 770


    59th Session, 1986
    World Health Organization
    Extracts: EN, FR
    Full Judgment Text: EN, FR

    Summary

    Extract:

    The complainant was injured in an aircraft accident while on an official mission. He sought compensation from the airline whose plane had caused the accident. The airline agreed to conclude a reasonable settlement. The complainant never disclosed the amount of the payment made to him. Under the circumstances, the Tribunal holds that it was proper for the organization to deny the complainant further benefits. Indeed, paragraph 32 of aAnnex E to the WHO Manual releases the compensation scheme from the obligation to make payments to a staff member who has obtained satisfaction through a third party.

    Reference(s)

    Organization rules reference: PARAGRAPH 32 OF ANNEX E TO THE WHO MANUAL

    Keywords:

    accumulation; health insurance; illness; insurance; medical expenses; organisation; professional accident; refusal; service-incurred;



  • Judgment 550


    50th Session, 1983
    Pan American Health Organization
    Extracts: EN, FR
    Full Judgment Text: EN, FR

    Consideration 4

    Extract:

    Judgment No 450 "did not dispose of the question of the repayment of the medical expenses the [organisation] had agreed to bear, and [the judgment] does not have the authority of res judicata on this matter. In fact both the [Appeals] Board and the Director were required to take the matter up. The Director's refusal to consider the claim to repayment of medical expenses therefore suffers from a mistake of law and on this point the impugned decision must be set aside."

    Reference(s)

    ILOAT Judgment(s): 450

    Keywords:

    flaw; health insurance; internal appeal; medical expenses; receivability of the complaint; res judicata;

    Consideration 3

    Extract:

    "On 7 May 1981 the chief of personnel gave a final decision on the claims[*] submitted by that date, but not on any which might be submitted later. The complainant did later make further claims but did not seek a final decision on them."
    [*] concerning reimbursement of medical expenses

    Keywords:

    date; health insurance; internal remedies exhausted; medical expenses; receivability of the complaint; request by a party;



  • Judgment 540


    49th Session, 1982
    World Health Organization
    Extracts: EN, FR
    Full Judgment Text: EN, FR

    Considerations

    Extract:

    Staff Rules impose a duty on the organization to provide a staff member with clear and precise information on all charges of which he is accused. In particular the complainant should have been informed of the period during which the WHO alleges he submitted medical and education grant claims supported by forged or false documents. "It is not difficult to conceive of cases in which such an omission would constitute an irreparable flaw in the procedure laid down". In the particular circumstances of this case, the Tribunal did not find that there had been a breach of the Rules.

    Keywords:

    duty to substantiate decision; education expenses; medical expenses; misrepresentation; refund; request by a party; serious misconduct; termination of employment;



  • Judgment 479


    47th Session, 1982
    World Health Organization
    Extracts: EN, FR
    Full Judgment Text: EN, FR

    Consideration 13

    Extract:

    Under the rules reasonable medical expenses should be reimbursed. The complainant asks the Tribunal to declare that he is entitled to reimbursement of expenses as long as his condition requires. No formal declaration is required. "If the complainant presents his claims as they arise and they are within the rule, there is no reason to suppose that they will not be met."

    Keywords:

    health insurance; invalidity; medical expenses; period;

    Consideration 4

    Extract:

    "The fundamental principle of the scheme [...] is that it is not a contract of indemnity but a contract to pay a fixed or calculated sum in certain contingencies. This principle is not affected by the adaptation of the scheme to short-term or temporary employment nor by the fact that in the latter case the earnings are not actual but assumed from an actual amount"

    Keywords:

    amount; health insurance; incapacity; invalidity; medical expenses;



  • Judgment 264


    35th Session, 1975
    European Organisation for the Safety of Air Navigation
    Extracts: EN, FR
    Full Judgment Text: EN, FR

    Considerations

    Extract:

    The complainant is right in claiming from the organisation "reimbursement of the difference between the amount to which she is entitled in respect of her husband and the amount to which her husband is entitled as an employee" of the Railway Corporation. The material provision is applicable, according to the general principles of existing law, even in the absence of express provision, irrespective of the sex of the official. If the official is a woman her husband should benefit from the sickness insurance if he does not himself benefit in his own right from a more favourable or equally favourable scheme.

    Keywords:

    amount; dependant; difference; health insurance; illness; insurance; medical expenses; right; supplementary coverage;



  • Judgment 250


    34th Session, 1975
    Universal Postal Union
    Extracts: EN, FR
    Full Judgment Text: EN, FR

    Considerations

    Extract:

    The illness which the complainant suffered during his appointment with the organisation left no mark on him and it did not prevent him from resuming normal work in his national administration nor from obtaining high-level responsibilities. Since the organisation met all expenses incurred by reason of his illness, the complainant suffered no other prejudice thereby and cannot properly claim compensation for disability from which he does not in fact suffer.

    Keywords:

    consequence; health insurance; illness; invalidity; lack of injury; medical expenses;



  • Judgment 157


    24th Session, 1970
    International Labour Organization
    Extracts: EN, FR
    Full Judgment Text: EN, FR

    Consideration 1

    Extract:

    On return from a mission, the complainant was ill. The organisation extended his contract for as long as the sick leave to which he was entitled under his contract. With the expiry of that contract, there was no longer any legal connection between the official and the organisation, which "could no longer lawfully grant him further sick leave or continue to bear his medical expenses." The organisation was bound by no provision nor any general principle of law to grant the complainant monetary compensation.

    Keywords:

    contract; extension of contract; fixed-term; health insurance; illness; medical expenses; non-renewal of contract; organisation's duties; project personnel; service-incurred; sick leave;



  • Judgment 148


    23rd Session, 1970
    Food and Agriculture Organization of the United Nations
    Extracts: EN, FR
    Full Judgment Text: EN, FR

    Consideration 7

    Extract:

    Due to his total incapacity for work, the complainant seeks the reimbursement of medical and pharmaceutical expenses in perpetuity. He "is entitled to reimbursement of such expenses only for as long as his condition so requires."

    Keywords:

    condition; health insurance; incapacity; medical expenses; professional accident; service-incurred;

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