Facts
A. (born in 1967) suffered an accident on April 27, 2009 during a unihockey game, in which he was injured in his left eye. The Swiss National Insurance Company AG (National) as the accident insurer acknowledged its obligation to provide benefits and rendered medical treatment services. By decree dated June 22, 2011, it awarded compensation for an 8% impairment of integrity, but denied the entitlement to a disability pension. At the same time, the granting of further medical expense benefits was rejected, but a coverage commitment for annual vision checks and accident-related eyeglass adjustments was issued.
By decree dated October 27, 2014, confirmed by the objection decision of January 21, 2015, National discontinued the assumption of the costs for vision checks and eyeglass adjustments, as these are to be borne by the mandatory health insurance according to federal court case law.
The Social Insurance Court of the Canton of Zurich overturned the objection decision and determined that A. continues to be entitled to annual vision checks and accident-related eyeglass adjustments.
As the legal successor to National, Helvetia Swiss Insurance Company AG filed a public law appeal to have the cantonal decision overturned and the objection decision of January 21, 2015 confirmed.
Considerations
The Federal Supreme Court dismissed the appeal. It stated that the entitlement to eyeglass adjustments and vision checks is to be classified as an aid device pursuant to Art. 11 AVIA and does not fall under the concept of medical treatment under Art. 19 para. 1 sentence 2 AVIA, which lapses with the case closure. Rather, there is a needs-based guarantee of existing rights beyond the case closure.
The Federal Supreme Court…