Dear Mrs D.,

On 20 February 2002, you made a complaint to the European Ombudsman concerning the European Commission’s failure to pay interest on the cost of a stay in a hospital in 1992.

On 18 April 2002, I forwarded the complaint to the President of the European Commission. The Commission sent its opinion on 9 August 2002. I forwarded it to you on 26 August 2002 with an invitation to make observations, which you sent on 19 September 2002.

I am writing now to let you know the results of the inquiries that have been made.

THE COMPLAINT

The complainant is the separated wife of an official of the European Commission. In 1992, she had to undergo treatment in a hospital in Italy and subsequently asked the Commission (or more precisely the RCAM, the sickness insurance scheme for the officials of the European Communities and their relatives) to reimburse the cost of this treatment amounting to LIT 19.6 m. This was refused. In May 2001, however, the Commission accepted to pay the complainant some LIT 20 m.

On 16 July 2001, the complainant turned to the Ombudsman (complaint 1036/2001/IP). The complainant argued in particular that the Commission ought to pay interest. The complaint was rejected on 23 July 2001 on the grounds that the complainant had not yet made the appropriate prior approaches to the Commission that are required by Article 2 (4) of the Ombudsman’s Statute.

After having made these approaches, the complainant renewed her complaint by fax and letter of 20 February 2002.

THE INQUIRY

The Commission's opinion

In its opinion, the Commission made the following comments:

The complainant had been hospitalised without requesting prior authorisation from the RCAM. Given that the complainant had herself taken up a professional activity in 1989, her own health insurance should have paid the bill in the first instance, with the RCAM only stepping in as a complementary scheme. Consequently, the RCAM had refused to pay the bill of LIT 19.6 m.

After several years of intensive correspondence, a compromise had been agreed between the RCAM and Mr. B., the lawyer representing the complainant. It foresaw that, despite the situation described above, the RCAM would in fact reimburse the full amount of LIT 19.6 m, on condition that this would be a final settlement of the case and that no further claims would be presented.

On 30 November 2000, the complainant had signed the following document:

[The complainant]

Considering:

- that she had been hospitalised (…) from 15 to 27 May 1992,

- that she wrongly believed, as the separated wife of an EU official, to be entitled to reimbursement from the Community health insurance, that she therefore had introduced the request for reimbursement,

- that, having received extensive explanations, she understood that she was not in fact entitled to any such reimbursement,

- that the RCAM, in order to help her solve her difficult situation, had decided to pay the sum of LIT 20 m, without this payment implying or establishing the recognition of any rights in her respect

Declares:

- that she accepts the payment of the above-mentioned amount and thanks the RCAM for this voluntary reimbursement, recognising that it does not constitute a right on her behalf but that it represents a generous voluntary benefit. She acknowledges receipt of the payment and renounces any further claims.

The payment of LIT 20 m (10 329 €) had been made in 2001.

The complainant had not been entitled to any reimbursement of the hospitalisation costs from the RCAM. As a gesture of goodwill to help the complainant out of a difficult financial situation, a generous voluntary payment had nevertheless been made in order to settle the case definitively. There was neither a legal nor a moral basis for any further payments to be made.

The complainant's observations

In her observations, the complainant reiterated the view that she was entitled to the reimbursement of the hospitalisation costs. She further pointed out that she had paid a sum of LIT 41.5 m to the hospital and that she claimed interest and damages as from 1992.

The complainant added that she considered the document that she had been made to sign was "vexatious".

THE DECISION

1 Failure to pay interest on hospitalisation costs

1.1 The complainant, the separated wife of an EU official, had to undergo treatment in a hospital in Italy in 1992. Her subsequent request to reimburse the cost of this treatment amounting to LIT 19.6 m was refused. Only in May 2001 the Commission accepted to pay the complainant some LIT 20 m. The complainant claims that the Commission should pay interest as from 1992.

1.2 The Commission takes the view that the complainant was not entitled to any reimbursement, given that she had not asked for prior authorisation and that her own health insurance should have paid the bill in the first instance. It adds that as a gesture of goodwill to help the complainant out of a difficult financial situation, a generous voluntary payment of LIT 20 m was nevertheless made in 2001 in order to settle the case definitively. The Commission points out that the complainant signed a declaration in which she accepted this payment and renounced any further claims. In the Commission’s view, there was thus neither a legal nor a moral basis for any further payments to be made.

1.3 The Ombudsman notes that the complainant has submitted a copy of the declaration to which the Commission refers with her complaint 1036/2001/IP. This declaration is dated 30 November 2000 and bears the complainant’s signature. The complainant there in effect renounces any further claims. The Ombudsman considers that the complainant has not put forward any evidence to demonstrate that this declaration would be invalid.

1.4 In these circumstances, the Commission’s view that there is no basis for any further payments to be made to the complainant appears to be reasonable.

2 Conclusion

On the basis of the Ombudsman's inquiries into this complaint, there appears to have been no maladministration by the European Commission. The Ombudsman therefore closes the case.

The President of the Commission will also be informed of this decision.

Yours sincerely,

 

Jacob SÖDERMAN