Home

In February 2017, Aetna, an insurance company administering the Applicant’s health insurance plan, denied her request, and subsequent appeal, for pre-approval for a particular medical procedure for her child. 6. In March 2017, the Applicant contacted the Chief of HLIS, who advised her that the Aetna plan does not cover the medical procedure in question and that she Case No.: UNDT/NY/2018/086 Judgment No. (...) The Chief of HLIS advised the Applicant that the requested medical procedure was covered under the Empire Blue Cross plan and that she may want to consider changing plans if she expected her child to undergo additional procedures beginning July 2018. (...) Claims for services and treatments not covered under the insurance programme are not covered under this process. 19.

Facts 4. The Applicant’s child is an undergraduate student at a public university in the United States. (...) Under sec. 3.2, if an expense is not covered by any of the categories listed in sec. 3.1, it is by default inadmissible. 10. (...) The Tribunal notes that a literal reading of sec. 3.1(a) plainly shows that only two statutory conditions apply for a fee to be covered by the provision, namely that (a) the fee concerns an eligible child’s enrollment in an educational institution and (b) the fee’s payment is obligatory for this purpose.

In the circumstances, the Respondent acted lawfully in recovering the salary paid to the Applicant whilst he was on unauthorised absence from work and that his health insurance cover ceased to be valid during this period. He asserts that the Applicant was advised to reactivate his insurance cover but that he failed to do so. (...) Given that the Applicant had been placed on SLWOP no contributions were being made towards its health insurance cover. In the circumstances his health insurance cover lapsed. (...) Education shall be deemed ‘primary’ for the purposes of this instruction when the child is five years of age or older at the beginning of the school year, or when the child reaches age five within three months of the beginning of the school year.

The Applicant further submits that the denial of her request was contrary to the spirit of the Organization’s policy on recognition of dependency status, as staff rule 3.6(a)(ii) intends to cover cases where the child is factually the equivalent of a natural, step or adopted child, but cannot be legally recognized as such, which is exactly the Applicant’s case. (...) … Dependency status of a child or children 3.1 In accordance with staff rule 3.6(b), a natural child, a legally adopted child, or a stepchild, provided the stepchild resides with the staff member, shall be recognized as a dependent child when the following conditions are met: Case No. (...) N is not the Applicant’s natural child, adopted child or stepchild. Therefore, the issue is whether Ms.

On 7 September 2017, UNON informed the Applicant that three admissible expenses, namely tuition fee, capital levy, and building and maintenance for one child, and tuition fee, registration fee, and building and maintenance for another child, were processed. (...) Appendix B(iv) provides that “admissible expenses for a child with a disability shall include those educational expenses required to provide an educational programme designed to meet the needs of the child so that he or she may attain the highest level of functional ability. (...) These fees are not to cover any special activities but to cover IT equipment and related service costs which are an integral part of the basic educational infrastructure. 102.

In the investigation report dated 7 January 2014, the OIOS made the following findings regarding the Applicant’s alleged misconduct: (i) [Child A, Child B, Child C and Child D] are the children and dependants of [the Applicant]. (...) These expenses may include: (i) Charges for teaching or training services; (ii) Other costs or fees directly related to the educational programmes that are not optional or related to extracurricular activities, except for inadmissible expenses set out in an information circular; (iii) Expenses for special equipment for educational purposes if not covered under health insurance; (iv) Expenses for full board (food and lodging) in the case of a child attending an educational institution at the duty station when such boarding is an integral part of the educational programme; (b) Expenses incurred for local transportation required for the child with a disability. (...) UNDT/2017/039/Corr.2 Page 23 of 78 13.1 The amount of the grant for each child with a disability shall be 100 per cent of the admissible educational expenses actually incurred, subject to the following maximum amounts: (a) The overall maximum amounts of the grant shall be as indicated in column 1 of the annex; (b) Within the applicable overall maximum amount: (i) Expenses for special equipment will be reimbursed up to a maximum of one third of the corresponding amount indicated in column 4 of the annex; (ii) Expenses for local transportation normally provided by the institution shall be reimbursed up to an amount equivalent to twice the cost of normal group transportation under section 3.1 above. 13.2 In the computation of the special education grant, the amount of admissible educational expenses shall be reduced by the amount of any benefits that may be available from other sources for the child’s education and training, which shall be reported as required by section 15.1. 13.3 The grant shall be computed on the basis of the calendar year if the child is unable to attend a regular educational institution or on the basis of the school year if the child is in full-time attendance at a regular educational institution while receiving special teaching or training. 13.4 If attendance of the child is for less than two thirds of the school year, or the period of service during which a staff member is eligible for the grant does not cover the full school year, the amount of the grant relating to expenses for school attendance shall be prorated in the proportion which the period of attendance or service bears to the full school year.

The grant shall be payable in respect of the child up to the end of the fourth year of post-secondary studies. (...) The grant shall be payable in respect of the child up to the end of the school year in which the child completes four years of postsecondary studies or attains a first post-secondary degree, whichever comes first, subject to the upper age limit of 25 years. (...) In the first case, the concept of acquired rights covers rights resulting from a service made, which are not touchable.

Education shall be deemed ‘primary’ for the purposes of this instruction when the child is five years of age or older at the beginning of the school year, or when the child reaches age five within three months of the beginning of the school year. (...) Additionally, the age for a child to start primary education was six years or if the child was to attain that age by the end of January of the relevant academic year. 41. (...) He was not entitled to any reimbursement for private mother tongue tuition in respect of the same child. The claim for mother tongue tuition in respect of the same child was therefore rightfully denied. 47.