Facts
The complainant, [A.] , was employed as head of the back office at company [X.] from October 1999 and was therefore compulsorily insured with Alba Allgemeine Versicherungs-Gesellschaft (Alba) against the consequences of accidents and occupational diseases. He terminated the employment contract on June 30, 2002, and decided on a "timeout" without professional activity. On January 25, 2003, [A.] suffered a snowboarding accident and sustained various injuries that required medical treatment and caused temporary incapacity for work. [A.] reported the accident to [X.] and Alba and claimed that an agreement insurance should be concluded retrospectively and benefits should be paid from January 25, 2003. Alba rejected this.
The Social Insurance Court of the Canton of Zurich dismissed [A.] 's complaint against Alba's decision. [A.] appealed to the Federal Court and requested that Alba be obliged to provide the statutory benefits from the accident of January 25, 2003.
Considerations
The Federal Court examined whether the lower court had wrongly denied the requirements for protection of trust. It found that the employer had not informed the employee about the possibility of agreement insurance. The employer's failure to provide information can, according to the principles of public law protection of trust, result in the insurance coverage being affirmed even in the absence of an agreement insurance.
The Federal Court concluded that the lower court had wrongly denied the requirements for protection of trust. It assumed that the complainant would have taken out the agreement insurance if he had been informed. The case was remanded to Alba to reconsider the complainant's claim for benefits in light of the considerations.
The Federal Court emphasized…