Facts
The 1950-born Italian citizen [N.] was employed as Chef de Service at Restaurant X. and was compulsorily insured against accident consequences with the "Zurich" Insurance Company. He fell off his scooter on December 31, 2002, and hit the right side of his body on the sidewalk. Due to thoracic flank pain on the right side, he visited the emergency department of Hospital Y., where two fractured ribs were diagnosed. From January 16, 2003, [N.] was under treatment by Dr. med. K., Rheumatology FMH. The latter confirmed a full incapacity for work in his report of January 17, 2003, and also attributed the lumbar pain that occurred in the course of the treatment to this condition in his report of March 17, 2003. The "Zurich" provided the statutory benefits (medical treatment; daily allowance). In the context of clarifying the facts, the accident insurer obtained, in addition to the reports of the treating physician, an expert opinion from Dr. med. S., Internal Medicine spec. Rheumatology FMH, Manual Medicine, dated June 27, 2003. Based on this, the "Zurich" informed the insured in a letter dated October 1, 2003, that the accident of December 31, 2002, was only causally relevant for the still existing problems in the back area until July 31, 2003. Nevertheless, they granted medical treatment until August 7, 2003, as a concession; the daily allowance had been paid until July 31, 2003. Thus, they discontinued their benefits with regard to the daily allowance as of August 1, 2003, and with regard to medical treatment as of August 8, 2003.
After [N.] had opposed this, the "Zurich" confirmed the discontinuation of benefits with a decision dated December 2, 2003. They upheld this decision in response to the insured's appeal (appeal decision of May 13, 2004). The Social Insurance Court of Basel-Stadt overturned the appeal decision of the "Zurich" of May 13, 2004, with regard to the limitation of medical treatment and daily allowance and obliged the "Zurich" to provide these benefits until October 31, 2003.
Considerations
The Federal Court had to decide whether medical treatment and daily allowance in accident insurance are considered ongoing benefits within the meaning of Art. 17 para. 2 GSSLA. The lower court had affirmed this and obliged the "Zurich" to provide the benefits until October 31, 2003.
However, the Federal Court came to the conclusion that medical treatment and daily allowance in accident insurance are not considered ongoing benefits within the meaning of Art. 17 para. 2 GSSLA. It based its decision on the legislative materials and case law, according to which medical…