Administratives
28.06.2000
INTERINSTITUTIONNELLE, TOUS LIEUX D'AFFECTATION + PENSIONNÉS
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| Informations Administratives 28.06.2000 | N° 56-2000 INTERINSTITUTIONNELLE, TOUS LIEUX D'AFFECTATION + PENSIONNÉS |
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 WHAT TO DO IN THE EVENT OF ACCIDENT OR ILLNESS DURING YOUR HOLIDAYS? SOME PRECAUTIONS TO TAKE
If you fall sick or have an accident while outside your country of residence, the cost of your transport home is never reimbursed by the sickness insurance fund (except under certain conditions for people posted outside the Community). To cover such eventualities it is advisable to take out private travel insurance (for example, from your credit card providers) of the type Europ Assistance or Mondial Assistance, etc. Under point XIII of Annex I to the Rules, the coverage provided by the sickness insurance fund is limited exclusively to transport costs in emergencies caused by sickness or accident (road accidents, sporting accidents, etc.), regardless of the type of transport used (ambulance, helicopter, etc.). The fund covers only the cost of the journey from the place where you are staying or where the accident happened to the nearest hospital, and the cost of a transfer to the nearest hospital with the correct equipment for treating you if this hospital cannot provide the appropriate treatment. The cost of travel back to one's country of residence is not generally reimbursed. Medical bills that you settle on the spot must be sent to the appropriate Settlements Office, together with the relevant supporting documents and proof of payment. The costs will then be reimbursed up to the maximum level, in the same way as the reimbursement of standard medical expenses. If you are hospitalised for more than two nights and you have not taken out private travel insurance of the "Assistance" type, you may apply to your Settlements Office for direct billing:
Since medical expenses can be very high in some countries (USA, Japan, South America, etc.), the non-reimbursed portion of the costs may nevertheless still be a substantial amount. It may therefore also be advisable to take out travel insurance for journeys to these countries. If you fall ill, have an accident or are hospitalised and have taken out private insurance (of the type Europ Assistance or Mondial Assistance, etc.), we advise you to first contact your private insurance company. In this way, if you need medical care during your stay abroad, the cost will generally be settled directly by your private insurers by way of an advance to you. Since private insurance policies function by providing cover supplementary to that afforded by statutory and complementary sickness insurance schemes, your insurer will submit the bills in question to your Settlements Office. After calculating the reimbursement rates, the Settlements Office will pay the reimbursement amount directly to your private insurers. All serving officials and temporary officials have world-wide coverage for accidents both at the workplace and in their private life (Article 73 of the Staff Regulations). However, Article 4 of the Rules on insurance against accidents, annexed to the Staff Regulations, excludes from coverage any accident resulting from regarded as dangerous, such as aeronautic or aerial sports, martial arts, speleology, underwater fishing and exploration with breathing equipment including containers for the supply of air or oxygen, etc. Note that this list is not exhaustive. Members of the families of officials and temporary officials, and retired officials are excluded from such coverage. However the medical expenses incurred by accidents involving these people will be reimbursed by the sickness insurance fund on the same conditions and at the same rates as for standard medical expenses. The new accident declaration form is available on the Institutions' intranet at the following address: http://www.europateam.cc.cec/guide/assmal/formulaires.htm This form must be sent within ten working days of the date on which the accident occurred to the following address: For officials of the Commission, the Agencies, the Court of Auditors, the Committee of the Regions and the Economic and Social Committee:
If you suffer an accident and are not able to have the doctor who provides the initial treatment fill out an accident declaration form, you can send in the declaration form and, at a later date, submit the initial accident report, completed and signed by your doctor and specifying the nature of the injuries, your previous medical history where relevant to the injuries and the probable medical consequences of the accident. If you were examined on the spot (X-rays, CT scanner, etc.), ask for a copy of the report to send in for your file (and keep the pictures yourself). In the event of sickness or accident during your holiday, you must notify both the Medical Service at your institution and your department. Medical services at the Commission (including the Court of Auditors):
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Direction A : Politique du personnel Editeur : Personnel et Administration Direction C : Ateliers de reproduction | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||