Health insurance (918,-666)

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Keywords: Health insurance
Total judgments found: 70

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• 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 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 402

  
  43rd Session, 1980
  World Health Organization
  Extracts: EN, FR
  Full Judgment Text: EN, FR

  Consideration 2

  Extract:

  "In some employments there are unavoidable risks. [...] The question in each case is whether the risk is abnormal having regard to the nature of the employment. In a case such as the present a reasonable test (though this is only one possible criterion) might be to consider whether an insurance company could, because of the civil war [...] properly demand an additional premium for cover against the risk of injury [...]. If so, the risk would be abnormal."

  Keywords:

  duty station; health insurance; insurance; special hazard; working conditions;
  

  
  
  

• 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;
  

  Considerations

  Extract:

  Under the applicable provision "an official's spouse is included among those who may be regarded as a staff member's dependant and as such is covered by sickness insurance. Such an interpretation of [the provision] reflects the actual situation of the spouses, who owe each other a duty of mutual assistance and who, when both are in gainful employment, may be regarded as mutually dependent."

  Keywords:

  definition; dependant; health insurance; illness; insurance;
  

  
  
  

• 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 173

  
  26th Session, 1971
  European Organization for Nuclear Research
  Extracts: EN, FR
  Full Judgment Text: EN, FR

  Consideration 1

  Extract:

  "The present complaint concerns the rate of disability pension payable under the regulations of the [organization's] staff insurance scheme [...] issued on the basis of the [...] staff regulations and rules and [...] regarded as forming part of them. The Tribunal is therefore competent to hear the complainant's claims. It is immaterial that [the regulations of the scheme] make no express provision for appeals to the Tribunal. Whatever the material legal texts in the light of which the complaint should be examined, the Tribunal's competence derives from its own statute."

  Reference(s)

  ILOAT Judgment(s): 141
  

  Keywords:

  competence of tribunal; disability benefit; enforcement; health insurance; insurance; provision; staff regulations and rules;
  

  
  
  

• 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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