Facts

This decision of the Swiss Federal Tribunal concerns the evaluation of impairment of integrity when it is partly due to an insured event (accident, injury equivalent to an accident, or occupational disease) and partly to non-insured pre-existing factors.

The different scenarios are as follows

  • An insured event leads to an impairment of integrity, the severity of which is evaluated according to the scale set out in Annex 3 of the Ordinance on Accident Insurance (OLAA). Supplementary guidelines have been developed by the Swiss National Accident Insurance Fund (SUVA).
  • Multiple insured events lead to different impairments of integrity. The integrity indemnity is then set based on the overall impairment, without exceeding the maximum amount of the insured annual salary.
  • Multiple events, some of which are insured and others not, lead to an impairment of integrity. The indemnity is then reduced proportionally to the part caused by the non-insured events.
  • When the damage includes multiple distinct impairments, with a part caused by insured and non-insured events, each impairment must be evaluated separately, and the indemnity reduced according to the part caused by the non-insured events for each impairment.

Considerations

The Federal Tribunal considers that, in the latter case, each impairment of integrity must be evaluated separately and the proportional reduction…