I A. GROUP MEDICAL SCHEME FOR UN/DESA FELLOWS & STUDY TOUR PARTICIPANTS

A group insurance contract has been signed with J. VAN BREDA and CO. INTERNATIONAL, Plantin and Meratuslei 295, B -2200 Antwerp, Belgium, for this purpose. The general conditions are indicated below and the medical coverage is indicated in the Annex.

1. Commencement and Termination of Coverage
The coverage will start on the day of commencement of the award. Coverage is for the entire period of the award up to and including the last day for which stipend or DSA is payable.

2. Insured Persons
Fellowship holders and study tour participants will be covered by the above medical scheme; dependents are not included in this coverage. To be eligible for this coverage, fellowship holder/study tour participant is required to send to the Training and Fellowships Section, UN/DDSMS, New York, 1) a statement of good health attested to by a duly-qualified physician if his/her tenure is up to one month, 2) an updated medical report and chest X-ray if his/her tenure is more than one month but less than six months, or 3) Medical Form MS22 Entry Medical Examination for Fellowship Candidate (complete exam & chest X-ray) if his/her tenure is over six months.

3. Submission of Claims
Claims for reimbursement of medical expenses must be submitted on the Document and Forms, preferably within three months from the date on which the expenses are first incurred. This form can also be obtained from the Training & Fellowships Section, DESA, New York. See contacts here.

This form is in triplicate: the fellowship holder or participant retains the pink copy, and sends the yellow copy and the top copy to:

J. VAN BREDA and CO. INTERNATIONAL, Antwerp, Belgium.

Please make sure that your name is clearly written in the same way with each and every claim. The name should be as indicated on the travel/payment instructions.

The claims for reimbursement should be submitted to J. VAN BREDA and CO. INTERNATIONAL directly together with a copy of your travel/payment instructions. Claims will not be reimbursable if submitted more than two years after the date on which the expenses were incurred for the first time during the insurance period.

If fellowship holders or participants are entitled to reimbursement by another Insurer, reimbursement by J. VAN BREDA and CO. INTERNATIONAL will be made as appropriate on the basis of the costs actually incurred and the reimbursement obtained from other sources. Claims for reimbursement must be accompanied by a statement of the diagnosis and the medical, surgical, pharmaceutical and hospital bills, etc., as well as by any payment slips made out by other Insurers (with details of the amounts reimbursed).

Confidential information may be sent under seal to the Medical Adviser of J. VAN BREDA and CO. INTERNATIONAL, who will provide the claims department only with that information which is essential to the processing of the claim.

4. In Case of an Accident
The fellowship holder or participant should mention the date, place and circumstances of its occurrence and, if possible, the names and addresses of any witnesses or legal authorities involved.

5. Settlement of Claims
Claims will normally be settled within two weeks, following the receipt of the written evidence by J. VAN BREDA and CO. INTERNATIONAL, by cheque in US Dollars. The conversion of medical expenses incurred in currency other than US Dollars will normally be made at the UN-operational rate of exchange in force on the date the claim form is signed. The United Nations will under no circumstances consider claims rejected by J. VAN BREDA and CO. INTERNATIONAL. Costs related to processing of claims, (e.g., postal charges) are to be borne by the fellowship holder or participant.

6. Medical Reservations
Neither the United Nations nor VAN BREDA will assume responsibility for medical expenses incurred by a fellow as participant in respect to medical conditions for which the Medical Service of the United Nations has made a medical reservation. The fellow or participant as well as VAN BREDA will be informed of the nature of the medical reservation by the Medical Service of the United Nations.