Staff case summary

Staff case summary

Summary

1. Officials – Social security – Sickness insurance – Medical expenses – Treatment requiring prior authorisation – Grounds for refusing reimbursement of costs incurred – No application for prior authorisation, or application not submitted properly

(Rules on sickness insurance, Art. 11(1)(c))

2. Officials – Social security – Sickness insurance – Decision rejecting a request for prior authorisation for a surgical procedure – Refusal on the ground of the exclusively cosmetic nature attributed to the operation – Incorrect appraisal by the competent authority

(Rules on sickness insurance, Annex I, Section II(5))

3. Officials – Actions – Subject-matter – Unlimited jurisdiction – Application for reimbursement of medical expenses under the Joint Sickness Insurance Scheme – Admissibility

(Staff Regulations, Art. 91(1))

4. Officials – Actions – Prior administrative complaint – Requirement that subject-matter and grounds be the same – Application for reimbursement of medical expenses relating to a treatment adjoined to an action against the refusal to grant prior authorisation for that treatment – Admissibility

(Staff Regulations, Arts 90 and 91)