Facts
This judgment of the Swiss Federal Court dealt with the calculation of overcompensation pursuant to Article 40 of the Federal Act on Accident Insurance (UVG) in the event of concurrent accident insurance daily allowances and disability insurance pensions.
The Swiss Mobiliar Insurance Company as the appellant disputed with M. and the Administrative Court of the Canton of Zug over the correct calculation method for overcompensation. While the insurance company advocated the principle of temporal congruence of benefits, the respondent argued for a global calculation from the date of the accident.
Considerations
The Federal Court decided that for the determination of overcompensation pursuant to Article 40 UVG, a global calculation is to be carried out in the sense of the case law on Article 74 paragraph 3 of the Federal Act on Health Insurance (KUVG). The start of the calculation period is to be set at the beginning of the entitlement to the daily allowance.
Furthermore, the court clarified that in determining the presumed lost earnings pursuant to Article 51 paragraph 3 of the Ordinance on Accident Insurance (UVV), the income actually earned from the utilization of residual earning capacity is to be deducted, but not hypothetical income that the insured person could have earned through reasonable utilization of the remaining work or earning capacity.
The Federal Court justified this by stating that the purpose of Article 40 UVG is to ensure that an insured person who receives benefits from multiple social insurance schemes as a result of the…