��ż���

The present case concerned the reimbursement of medical expenses incurred by a locally recruited staff member outside his duty station while travelling on private business. As the conditions for reimbursement and the extent of the coverage are detailed in the Medical Insurance Plan (“MIP”) Rules, the Tribunal’s role essentially consisted in examining whether UNHCR committed any error, in law or in fact, in the interpretation or the application of these rules.; The Tribunal identified the following issues:; Was the Applicant entitled to the benefit of the stop-loss provision?; The Tribunal considered that the MIP Rules clearly provide that only reasonable and customary expenses at the duty station are covered by the MIP and are, thus, considered as “recognized expenses” unless one of the exceptions set out in sec. 6.3 applies, which; is not the case here (see secs. 6.2, 6.4, 4(aa)). The out-of-pocket amount for the purpose of the stop-loss provision represents the unreimbursed portion of these recognized expenses and thus does not include expenses exceeding the reasonable and customary ones at the duty station. This provision applies to expenses that are covered by the MIP but not reimbursed in full. This is not the case for medical expenses incurred out of the duty station, for which there is a limitation in the coverage.; The Tribunal found that the Director, DHRM, and the Controller and Director, DFAM, were thus correct in not applying the stop-loss provision contained in sec. 6.25 of the MIP Rules.; Did UNHCR commit any procedural or factual error in the assessment of the reasonable and customary expenses at the Applicant’s duty station?; Given that the MIP Rules do not require the administering office to establish the prevailing pattern of charges based on multiple quotations, and that the Applicant had not raised any concern related to the fact that the “American Hospital” was a valid reference to establish reasonable and customary expenses at the duty station, the Tribunal found no error in the procedure that the administering office used for the establishment of recognized medical expenses.; The Tribunal also found no evidence that would allow to question the basis of the calculation used to establish reasonable and customary expenses at the duty station in the Applicant’s case.; The Tribunal therefore found no discernible error in the establishment of the amount of reasonable and customary expenses at the duty station.; Did the attestation of 3 August 2015 issued in support of the Applicant’s visa request for his travel to Greece constitute a promise by UNHCR that his medical expenses in Switzerland would be covered and reimbursed in full?; The Tribunal noted that the source of law in this case is the MIP Rules, which are adopted through an administrative instruction and are binding upon the parties. An attestation issued by a Human Resources Officer to facilitate a visa for a private travel had no legal authority to derogate from the MIP Rules.; Therefore, the Tribunal considered that the attestation cannot be seen as a promise binding the Organization to pay for medical expenses falling outside the scope and limits of the MIP.; Based on all of the above, the Tribunal found that the Applicant had not demonstrated any discernible error in the interpretation or application of the MIP Rules. The Director, DHRM, and the Controller and Director, DFAM, were bound to apply these rules, which are clear, objective and very detailed, leaving no room for administrative discretion. The MIP rules clearly define the threshold for reimbursement, the concept of reasonable and customary expenses and the methodology to properly assess them. The contested decision was a mere application of these rules.