Facts
The case concerns a dispute between the Swiss Accident Insurance Institution (SUVA) and Helsana Insurance AG regarding the question of whether the requirement of an external factor is met for certain health impairments to be considered accident-like bodily injuries pursuant to Art. 9 para. 2 of the Ordinance on Accident Insurance (UVV).
The Federal Supreme Court had previously held in earlier decisions (BGE 123 V 43, RKUV 2001 No. U 435) that in the case of accident-like bodily injuries, in addition to the unusual nature, the other elements of the definition of an accident must also be fulfilled, in particular the existence of an external event. The Federal Social Insurance Office (BSV) requested a change in this case law, which the Federal Supreme Court, however, rejected.
In the present decision, the Federal Supreme Court concretized the requirement of the external factor. It stated that the mere occurrence of pain as such does not constitute an external factor. Rather, the activity leading to the pain must have an increased risk potential, either because it is carried out within the framework of a generally increased hazard situation, such as in sports activities, or because it means a more than physiologically normal strain on the body.
Considerations
The Federal Supreme Court upheld its previous requirement of an external factor and concretized it to the effect that cases in which pain occurs only when performing everyday life activities, without a distinguishable external moment occurring, cannot be considered accident-like bodily injuries. The…