Facts
The complainant, [S.] , was compulsorily insured with AXA Versicherungen AG against the consequences of accidents and occupational diseases. After termination of his employment contract and subsequent illness, he was released by the employer. The collective daily sickness benefit insurance paid him a daily allowance. The complainant fell and injured himself on February 16, 2006, as a passenger during an emergency stop of a tram and reported this incident to AXA as an accident. AXA denied AIA coverage, as the complainant had left the employer's operation as of August 31, 2005, and coverage had therefore ended 30 days later.
The Insurance Court of the Canton of Aargau dismissed the complainant's appeal, insofar as it was entertained. The complainant requested the Federal Court to order AXA to pay him an AIA daily allowance and an AIA pension.
Considerations
The Federal Court examined whether the incident of February 16, 2006, was insured with the defendant under AIA. It found that compulsory accident insurance ends with the 30th day after the day on which the entitlement to at least half of the salary ceases. The cantonal court had qualified the daily allowances paid directly to the insured by the collective daily sickness benefit insurer on the basis of the contract between the employer and the insurer from September 1, 2005, as insurance benefits rather than salary replacements.
The Federal Court concluded that the lower court had rightly denied AIA insurance coverage for the accident in question due to the lack of abredeversicherung. However, it found that the questions of whether the information obligation under Art. 72 AIO and/or the conclusion of an abredeversicherung pursuant to Art. 3 para. 3 AIA had been fulfilled were not the subject of the previous proceedings.
The Federal…