Facts
The Federal Court dealt with the question of when the accident insurer may close a case and examine the entitlement to a disability pension and an integrity compensation. It clarified that the accident insurer is only obliged to provide medical treatment and daily allowance as long as a significant improvement in the state of health can still be expected from the continuation of medical treatment. If this is no longer the case, the case must be closed with the suspension of the temporary benefits and simultaneous examination of the entitlement to a disability pension and integrity compensation. In the case of injuries without organically verifiable complaints, such as whiplash injuries of the cervical spine, the accident insurer must carry out a special adequacy examination. The Federal Court specified the relevant criteria for this and emphasized that high requirements must be placed on the basis for the conclusion that such injuries are present. In particular, a detailed medical clarification (multidisciplinary/interdisciplinary expert opinion) is required if there are indications of a longer duration or chronification of the complaints.Considerations
The Federal Court upheld the administrative court appeal of Allianz Suisse Versicherungs-Gesellschaft. It set…