Reimbursement of Repair Costs for Auxiliary Devices Personally Acquired by the Insured

Facts

Jeannette N., born in 1959, suffers from spastic tetraplegia following a traffic accident in 1970. She works in a sheltered workshop and was granted an electric wheelchair by the Disability Insurance (InvIA) in 1980. In 1985, she requested reimbursement of repair costs, but the compensation fund only granted her a lump-sum contribution of 20% of the initial cost of the wheelchair. Jeannette N. then filed a claim with the Insurance Court of the canton of Basel-Campagne.

Considerations

The case law of the Federal Social Insurance Court has always considered that the various forms of provision or benefits for auxiliary devices should be treated equally. Thus, for auxiliary devices personally acquired by the insured, it is permissible to allocate a lump-sum amount for repair costs. However, the insured can demand reimbursement of the actual repair costs that exceed this lump-sum amount, provided that the repair is simple and adequate for the auxiliary device.

The Federal Court considers that the possibility offered to the insured to procure an auxiliary device themselves should not disadvantage them compared to the one who receives the auxiliary device in kind from the Disability Insurance (InvIA). Indeed, in many cases, the insured does not really have a choice in the…