Facts
The case concerns the question of which social insurance benefits should be taken into account in the calculation of overcompensation under Art. 40 of the Accident Insurance Act (UVG). The Swiss National Insurance Company and the Federal Social Insurance Office (BSV) take the view that the period during which the Disability Insurance paid daily allowances instead of the accident insurer should be excluded from the overinsurance calculation. The respondent, on the other hand, argues for a global calculation from the date of the accident.
The cantonal court has decided that the entire period during which the Disability Insurance provided benefits instead of the accident insurer based on Art. 16 para. 3 UVG and Art. 25bis IVG should be included in the overinsurance calculation, as the legal entitlement under the UVG was merely replaced and covered by the benefits of the Disability Insurance.
The administrative court appeal argues that Art. 16 para. 3 UVG expressly exempts the accident insurer from its obligation to provide benefits and that during the period of daily allowance payments by the Disability Insurance, there was neither an entitlement to benefits from the accident insurer nor were any benefits provided by it. The starting point for a global overinsurance calculation under Art. 40 UVG could therefore only be the actual benefit periods under this Act.
Considerations
The Federal Insurance Court has consistently ruled that for the determination of overcompensation pursuant to Art. 40 UVG, a global calculation must be carried out, which covers the entire period from the inception of the entitlement to daily allowances from the accident insurance.
Art. 16 para. 3 UVG does indeed exempt the accident insurer from its obligation to provide benefits as…