Facts
Katharina [H.], born in 1963, suffered a severe open traumatic brain injury as a result of a motorcycle accident on May 29, 1983, requiring a decompressive craniectomy and replantation of the cranial vault. Among the sequelae of the accident, she retained a moderate impairment of brain functions with motor aphasia, partial epilepsy, and predominant right-sided hemiparesis of the arm. From November 15, 1983, to December 7, 1984, she underwent a rehabilitation program at the Bellikon Clinic, mainly consisting of physiotherapy, occupational therapy, and speech therapy sessions. The costs of this stay were covered by the private accident insurance company [Z.], with which Katharina [H.] was insured through her employer. On April 3, 1985, insurance company [Z.] requested reimbursement of these rehabilitation costs by the Disability Insurance (DI), but the compensation fund of the canton of Berne refused this coverage on May 31, 1985.Considerations
The Insurance Court of the canton of Berne upheld Katharina H.'s appeal and ordered the compensation fund to cover the costs of the rehabilitation stay as a medical measure.
The Federal Insurance Court considers that the rehabilitation measures provided in Bellikon are an integral part of the initial treatment of the accident and are therefore the responsibility of the accident insurance, and not the Disability Insurance (DI). Indeed, these measures aimed to optimize the remaining…