Facts
A., born in 1987, was mistakenly arrested by the police on June 5, 2005. He reported this to the Swiss Accident Insurance Fund (Suva) and claimed psychological complaints. Suva acknowledged its obligation to provide benefits, granted medical treatment until May 2011 and paid daily allowance until June 2011. However, the Disability Insurance rejected a pension claim, which was ultimately confirmed by the Federal Supreme Court.
By order dated March 7, 2013, Suva revisited the benefits it had provided since September 1, 2005 in the context of a procedural revision. It recognized that from this date onwards, there was no longer any entitlement to benefits and that A. had received the benefits unduly, which were therefore to be reclaimed. By a legally binding decision of the criminal court dated July 1, 2014, A. was found guilty of commercial fraud.
Considerations
The Federal Supreme Court confirmed the view of the cantonal court that the 90-day revision deadline had been met. The decisive factor is that Suva only gained definitive knowledge about whether and until when the appellant suffered from an insurmountable post-traumatic stress disorder (PTSD) after receiving the Federal Supreme Court judgment 8C_483/2012 of December 4, 2012. Only at that point in time could Suva have the definitive knowledge of the new significant fact required for a revision.
The Federal Supreme Court states that an observation report alone does not provide a secure basis for factual findings on the state of health and the ability to work of the insured person. Definitive knowledge in this respect can only be provided by the medical assessment of…