Reimbursement of medical expenses by the insurer in case of coverage by a third party

Facts

On April 12, 1969, an intoxicated military driver collided with the vehicle of Heinrich Fux, seriously injuring him and three members of his family. The medical expenses amounted to a total of CHF 10,318.80 and were covered by the liability insurance of the military vehicle. Heinrich Fux had taken out a combined "Autoplan" insurance policy with Altstadt-Versicherungs-Aktiengesellschaft, which covered, among other things, the medical expenses of passengers. However, the general conditions of this insurance policy provided that the reimbursement of medical expenses would be excluded to the extent that these expenses were covered by a third party. Heinrich Fux and his family therefore filed a lawsuit against the insurer Altstadt to obtain reimbursement of the full amount of medical expenses, despite the coverage by the liability insurance of the military vehicle.

Considerations

The Federal Tribunal considers that the insurance for medical expenses must be qualified as personal insurance, and not as property insurance, in accordance with its consistent case law. Thus, under Art. 96 IPA, the right of the injured party to claim reimbursement of his medical expenses from the insurer is not extinguished by the fact that these expenses have already been covered by the party responsible…