A health insurer for United Nations staff is refusing to pay medical fees in Iran for a gravely ill 84-year-old who cannot leave the country after serving part of a 10-year jail-term on trumped up espionage charges. Baquer Namazi, a former senior Unicef official, needs surgery within days to fix a blocked artery to his brain but has been barred by Iran from leaving the country and his insurer refuses to pay medical fees for fear of breaking US-imposed sanctions. The family appealed to US President Joe Biden and the UN Secretary-General Antonio Guterres to do everything they could to get Mr Namazi out of the country for treatment. But the family is being forced to confront having surgery in Iran, where the chances of a successful recovery are much lower in a health service ravaged by Covid-19. Mr Namazi’s overseas medical fees are covered by US-based insurer Aetna but the company refused to pay part of his latest bill because the claim is “from a country or provider under sanction from the United States”. “We can’t pay for services provided in a country or provider under sanctions,” Aetna said in a statement provided by the family’s lawyer. Mr Namazi, a US-Iranian dual national, was detained when he flew to Tehran in 2016 to visit his son Siamak, the head of an oil and gas company based in the UAE, who was arrested the previous October and held in the country’s notorious Evin jail. The pair were later that year convicted of collaborating with the US and each jailed for a decade. While Siamak remains in prison, Baquer Namazi was released on medical grounds in 2018. Although his sentence was commuted to time served last year, the authorities have not allowed him to leave the country. The family made their latest desperate plea for him to be allowed to leave on Monday, following worsening medical reports. Surgery in Iran is a desperate last resort but the family cannot afford to pay for the treatment inside Iran without their medical insurance coverage. They have repeatedly tried to persuade Aetna to change its stance without success, said Jared Genser, the family’s lawyer. Mr Genser said the family were also speaking with Mr Biden’s administration and the Office of Foreign Assets Control (Ofac), which administers the US sanctions regime. “Someone has to pay for this emergency surgery and right now the Namazis don’t have the resources to pay for it,” said Mr Genser. “It’s another reason why Baquer needs to be out of Iran because the moment he is in a different country — at least as of now — Aetna would pay.” He said the 168-year-old insurance firm based in Hartford, Connecticut, had previously reimbursed medical costs incurred by Mr Namazi in Iran. “They can’t really have it both ways — either they were violating Ofac regulations and they should be in very, very serious trouble … or they weren’t.” The Aetna plan is listed on the UN’s website offering medical care worldwide for current and former staff and their dependents who voluntarily join the plan. The company said it was investigating the issue but did not immediately respond to a request for comment.