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WHAT TO DO IN THE EVENT OF ACCIDENT OR ILLNESS DURING YOUR HOLIDAYS?
SOME PRECAUTIONS TO TAKE
- HOW ARE MEDICAL COSTS REIMBURSED?
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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 need to be hospitalised, first of all call on your travel insurance
company, if you have one. In fact, these companies pay all the costs on
the spot while the JSIS only pays directly if you are in hospital for at
least two nights.
To obtain a letter of direct billing from the JSIS; contact your
Settlements Office:
Brussels: |
Tél.: (+ 32) 2.295.98.56 |
- Fax: (+ 32) 2.295.97.01 |
Luxembourg: |
Tél.: (+ 352) 4301.36103/36406 |
- Fax: (+ 352) 4301.36019 |
Ispra: |
Tél.: (+ 39) 0332.789966/5757 |
- Fax: (+ 39) 0332.789423 |
Karlsruhe: |
Tél.: (+ 49) 7247.951-534 |
- Fax: (+ 49) 7247.22696 |
Council: |
Tél.: (+ 32) 2.285.63.47 |
- Fax: (+ 32) 2.285.87.38. |
For those people (spouses, children, ...) who have their primary insurance
with a national system, find out before you leave about the procedures to
be followed in case of treatment in another country (for example the E111
form / European Health Insurance Card for EU member states, some other
document in case of a bilateral agreement, etc ...).
- BE CAREFUL OF INCURRING HIGH MEDICAL EXPENSES, ESPECIALLY IN COUNTRIES
OUTSIDE THE EUROPEAN UNION!
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The cost of medicine is so high in some countries (USA, Japan, South
American, etc.) that even after the sickness scheme’s reimbursement, you
could be left with a very large amount to pay yourself.
This is obvious for those expenses subjected to a maximum reimbursable
amount, but is also true for those whose reimbursements are not limited by
the Sickness Rules (for example X-ray costs, laboratory analyses, certain
hospitalisation costs, etc). In these cases, the reimbursements could be
limited by the Settlements Office to the tariffs pratised in Europe. These
limits could also be applied in the case of a serious illness.
A special reimbursement (cf. Article 72§3 of the Staff Regulations) is
foreseen when these expenses reach a certain level, but some are not taken
into consideration during the calculation of this reimbursement.
If you are hospitalised for at least two days, you are advised to pay
nothing directly to the hospital, but to ask for a letter of direct
billing.
If you plan to stay in one of these expensive countries, you are advised
to take out extra insurance in accordance with your personal situation.
- WHICH TRANSPORT COSTS ARE COVERED BY THE SICKNESS INSURANCE SCHEME?
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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 scheme. To cover such eventualities it is advisable to
take out private travel insurance (for example, from your credit card
providers, if you have paid for your trip in this way).
The coverage provided by the sickness insurance scheme 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 scheme 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 home is not generally reimbursed.
- PROCEDURE TO BE FOLLOWED IF YOU HAVE PRIVATE INSURANCE
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If you fall ill, have an accident or are hospitalised, 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. In fact, in most cases, private
insurance companies will pay your bills for you and will later recuperate
from the Settlements Office the amount it would have reimbursed you,
without you making any payment at all.
- COVERAGE PROVIDED BY THE ACCIDENT INSURANCE SCHEME
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All serving officials, temporary officials and contract staff(1) have
world-wide coverage for accidents both at the workplace and in their
private life, with the exception of those resulting from sports regarded
as dangerous (parachuting, boxing, karate, speleology, underwater fishing
and exploration with breathing equipment including containers for the
supply of air or oxygen).
Members of the families of officials, temporary officials and contract
staff, as well as retired officials are excluded from such coverage.
However the medical expenses incurred by accidents involving these people
will be reimbursed by the sickness insurance scheme on the same conditions
and at the same rates as for standard medical expenses.
In all cases, if the accident is the fault of a third party, you should
send a note to the Accident Sector, recounting the details, as well as
giving the contact details of the person(s) responsible. The Accident
Sector will claim back from the person responsible any reimbursements it
has had to make. A medical certificate must be annexed, specifying the
nature of the injuries and the probable consequences of the accident.
The accident declaration form is available on the Institutions' intranet
at the following address:
http://intracomm.cec.eu-admin.net/pers_admin/sick_insur/form_en.html
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: |
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Brussels |
European Commission |
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Unit PMO/3 |
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Accident and Occupational Disease Sector |
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Building B-28 3/15 |
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B-1049 Brussels |
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E-mail address:
accidents-maladies-prof@ec.europa.eu |
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Tel.: 02 296.05.95 |
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Luxembourg |
European Commission |
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Caisse de Maladie |
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Unit PMO/5 |
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(Wagner C2/02) |
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Plateau du Kirchberg |
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L-2920 Luxembourg |
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Ispra C.C.R. |
Ufficio liquidatore |
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Unit PMO/6 |
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TP 640 |
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I-21020 Ispra (Varese) |
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Court of Justice: |
Court of Justice |
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Personnel Division |
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Erasmus Building |
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L-2925 Luxembourg |
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Council: |
General Secretariat of the Council of Ministers |
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"Accident Insurance" Service |
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Building "Justus Lipsius" 03 70 FK 30 |
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175, rue de la Loi |
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B-1048 Brussels |
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Fax: 02 285.64.92 |
European Parliament and European Ombudsman: |
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Mrs Woillot |
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KAD 2D 016 |
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Plateau du Kirchberg L-2929 Luxembourg |
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Tel.: (+ 352) 4300.22528/25272/24814 - Fax: 434969 |
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).
- WHICH DEPARTMENTS DO YOU HAVE TO INFORM?
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In the event of sickness or accident during your holiday, you must notify
both the Medical Service at your institution and your department.
If you are sick while on annual leave, you can recuperate these leave days
by faxing to your Medical Service within 48 hours a copy of your medical
certificate which should indicate the beginning (and if possible the end)
date(s) of your illness. Indicate that you are on annual leave and mention
also the address where you are staying and a mean of contact (phone or fax
number). The precise rules in this respect (documents to be submitted,
timescale permitted) may vary slightly from Institution to Institution.
Medical services at the Commission (including the Court of Auditors): |
Brussels: |
Tel.: (+ 32) 2.295.69.83/4 |
- Fax: (+ 32) 2.299.20.56 |
Luxembourg: |
Tel.: (+ 352) 4301.32588/32589 |
- Fax: (+ 352) 4301.34711 |
Ispra: |
Tel.: (+ 39) 033278.9965 |
- Fax: (+ 39) 033278.9051 |
Karlsruhe: |
Tel.: (+ 49) 7247.951444 |
- Fax: (+ 49) 7247.951591
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Medical service at the Council:
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- Fax: (+ 32) 2.285.82.64
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Medical services at the European Parliament:
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Brussels: |
Tel.:(+ 32) 2.284.21.23 |
- Fax: (+ 32) 2.284.90.00 |
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- E-mail:
BMedical@europarl.eu.int |
Luxembourg: |
Tel.: (+ 352) 4300.23976 |
- Fax: (+ 352) 4300.24719
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Medical service at the Court of Justice:
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Tél.: (+ 352) 4303.3648 |
- Fax: (+ 352) 4303.3113
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Medical service at the Committee of the Regions and the European Economic
and Social Committee: |
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Tel.: (+ 32) 2.546.95.83 / 282.22.58
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- Fax: (+ 32) 2.546.96.01.
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For the Committee of the Regions and the European Economic and Social
Committee, the Medico-Social Department can be contacted for a letter of
direct billing, an accident declaration or a sickness insurance carnet. |
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Tel.: (+32) 2.546.94.50 |
- Fax : (+32) 2.546.96.01. |
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Footnotes (1)
For contract Staff, only if he is covered by the Community Scheme, as he
may request under certain conditions to be covered by a national Scheme.
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