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In January this year, we informed you about our success with an application for extraordinary reimbursement of the medicine OPDIVO (nivolumab) at the Supreme Administrative Court. Our client was an oncological patient whose chemotherapy treatment failed completely, and the only option for him was immunotherapy in the form of the drug OPDIVO.
The Supreme Administrative Court disagreed with the opinion of both the health insurance company and the Municipal Court in Prague, and concluded that the conditions for extraordinary reimbursement under Section 16 of the Public Health Insurance Act were fulfilled in this case as OPDIVO was the only remaining treatment option for the patient. The Supreme Administrative Court overturned the previous decision of the health insurance company and the Municipal Court in Prague, and returned the case to the insurance company for approval of the application.
The problem that arose thereafter was that the client had already paid for the treatment as his health condition was very serious, and it was not possible to wait any longer. However, reimbursement from public health insurance is usually made only after the treatment has been approved, and the insurance company subsequently sends the payment directly to the account of the health service provider, and not to the patient. However, on the basis of our urgency, and thanks to cooperation from the health service provider, the insurance company was able to pay the health service provider for the treatment cost, which was then refunded to the client by the health service provider.
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Stewarts
'No one has done as much for me as you,' Eva said.
Stewarts
"A visit to her daughter in London turned Eva's life upside down when she says she stepped into a crossing on a green light but was hit by a car. Despite her remarkable bravery, she faced a long treatment due to fractures in her pelvis, and the associated limitations and pain are likely to persist for the rest of her life. Regular headaches and impaired concentration compound her challenges.
Eva contacted us through an organization temporarily helping her manage her difficult living situation. At that time, she was destitute, relying only on subsistence payments. We were able to assist her because we specialize in personal injury and have contacts with proven colleagues abroad.
We worked with Stewarts, a UK law firm, on this case. Attorneys Klára Dvořáková and Rebecca Huxford helped Eva with the documentation in her case, explaining her options and the differences between the Czech and British systems of healthcare and social benefits reimbursement. Within a few months, thanks to the professional cooperation between the two offices, an offer of compensation from the insurance company of approximately CZK seven million was achieved. The client accepted this settlement because she did not want to deal with courts in the United Kingdom.
Subsequently, we assisted the client with related tax issues and contacted Auditone, a tax consultancy firm, which arranged for the filing of a tax return. Compensation for lost income is taxable, unlike most personal injury compensation.
'No one has done as much for me as you,' Eva said.
The fact that we were able to help Eva gives our work meaning and brings us great joy. We are very happy that, thanks to our many years of active involvement in the international professional organization PEOPIL, we can cooperate on such cases."
Livingstone, Tour Operator
Thank you again for your valuable advice. I breathe better when I know who to turn to.
Livingstone, Tour Operator
"Thank you again for your valuable advice. I breathe better when I know who to turn to."
Anders Thorsen Advokatanpartsselskab
It has been an absolute pleasure to work with you.
Anders Thorsen Advokatanpartsselskab
"It has been an absolute pleasure to work with you and your colleagues. Your advice and way of handling the matter and our communication has been of the highest quality and we are very happy with the outcome.
If any of my clients need assistance in matters in the Czech Republic in the future, I know who to recommend."