Harden your heart against the setter’s siren charms. Court may mean WOO but can also be shortened to CT, as in a street name.ģ. Can sometimes means IS ABLE but can also be a TIN. In the clue above: former lover often means EX. It gives you another way to get the solution. The part of the clue that is not the definition is known as the subsidiary indicator. As was said in Judgment 1088, 24 covers all sorts of 'treatments', however the term 'pharmaceutical product' in 14 is to be construed.2.
"Eurocontrol has discretion under Article 24, which empowers the fund to refuse refund of the costs of treatment which the medical officer deems to be 'non-functional, superfluous or unnecessary'. The complainant objects to the Sickness Fund's refusal to refund the costs of a given item. Likewise a doctor's prescription is no criterion since according to the rule it is a condition of refund over and above the objective effects of the product." Keywordsįreedom to choose practitioner discretion medical expenses health insurance The Tribunal holds that the fact "that a product has been bought in a pharmacy since a pharmacy may sell many health items that are not products within the meaning of the rule. The complainant objects to the Sickness Fund's refusal to refund the costs of a product which her doctor prescribed and which she bought in a pharmacy. General decision individual decision administrative instruction discretion medical expenses health insurance It may adopt general rules or else it may take individual decisions on particular cases." Keywords There is more than one legal procedure it may resort to. "The organisation has wide discretion in the matter and may exercise it as it sees fit for the purpose of ensuring the efficiency and financial soundness of its fund. The organisation notified this decision to her by an office memorandum and it constituted an individual decision. The complainant objects to the refusal by Eurocontrol's Sickness Fund of her claim to the refund of costs incurred for treatment. Organization rules reference: ARTICLE 14 OF RULE 10ĭomestic law freedom to choose practitioner insurance benefits discretion medical expenses health insurance
#Cryptic byword free#
So decisions by public health bodies are highly relevant, particularly for an international fund like that covers more than one country and allows free choice of practitioner." Reference(s) That is a matter of medical opinion and among the relevant criteria are the preventive or therapeutic efficacy of the product, scientific inquiry into the effects it has, and any risks involved in using it.
The Tribunal holds that "under Article 14 the administration may determine whether an item that a fund member wants to have refunded is a 'pharmaceutical product' within the meaning of the rule. The complainant is challenging Sickness Fund's refusal to refund the cost of an item classified as "phytotherapy". She acted in time." Keywordsĭecision confirmatory decision time limit start of time limit refund medical expenses health insurance The 'act adversely affecting' her - to quote the Regulations - did not become specific until she got the and so that is the date at which the time limit for her internal appeal began. The cryptic allusion in the statement to 'non-refundable items' did not suffice to tell the complainant just what she was being refused. Eurocontrol contends that the time limit ran from the date at which she got the original statement from the Fund, the later note having merely confirmed the earlier decision. Only later did a note indicate which items were being refused. Having submitted a claim for the refund of the costs of an item, the complainant first received a statement from the Sickness Fund which alluded to "non-refundable items".