H021 - Reply to Claim for Reimbursement – Administrative Check/ Medical Information

The SED H021 is used to reply to a SED H020 ‘Claim for Reimbursement – Administrative Check/Medical Information’ which informed you about a creditor institution’s demand to reimburse justified costs of (effective amount of the expenses) of the medical information provided or medical examination(s) or administrative check(s) carried out in accordance with Article 87 (1-5) of Regulation (EC) No 987/2009. The H021 refers then either to one claim only (where the global claim concerned expenses for one of them) or to several claims added together (where the global claim is the total sum/ collection of several claims, concerning one person). In either case, sufficient identification data for (each) claim has to be provided.

The reply SED covers the global part and the part referring to (each) claim. If there were more than one cases covered, then a reaction to each case is described in a separate/ additional block. Three actions are possible in reference to (each) claim:

Acceptance (acceptance of the claim or all claims meant as no rejection of any claim);

Partial rejection (of part of the claim or of one of the claims);

Full rejection (of a claim or all claims).

In case of partial or full rejection details are required/highly recommended, including reasons.

Acceptance by virtue of SED H021 means that you agree to the claim and accept the obligation to transfer the requested amount to the creditor institution.

If you reject some or all of the claim(s), or some of the expenses from some or all of the claims, please make sure to give appropriate reasons for each of your (partial) refusals.

Any payments carried out to the benefit of the creditor institution needs to carry appropriate identification. Identification of a payment of the

global claim is provided by the payment reference stated by the creditor institution in the SED H020 and should be repeated in H021. Identification of a payment of each claim usually equals to (national) invoice number (plus eventual further data like case number) and is provided by the creditor institution in H020 and should be repeated in H021..

It is possible to add attachments to SED H021.

In order to see the content and explanatory notes of SED H021 please click here.