Facts
No accident-like bodily injury during golf **Parties:** - Appellant: AXA Insurance AG - Respondent: [A.] **Facts:** - [A.] , born in 1970, was employed by [B.] and insured against accident consequences with AXA. - On June 10, 2015, he suffered a complex meniscus tear and cartilage damage to his right knee while playing golf. - AXA refused accident insurance benefits, stating that it was not an accident or an accident-like bodily injury. - The Social Insurance Court of the Canton of Zurich upheld [A.] 's appeal and granted him benefits. - AXA filed an appeal with the Federal Supreme Court. **Relevant Facts:** - The event was described differently by [A.] , with the accounts becoming more detailed over the course of the proceedings. - The lower court assumed a mishit in difficult terrain conditions. - AXA argued that the descriptions of the incident were contradictory and that the lower court had disregarded the evidentiary principle of the "statement of the first hour.\" **Reasoning:** An appeal in public law matters can be filed for violations of law pursuant to Art. 95 and 96 FSCA. The Federal Supreme Court applies the law ex officio (Art. 106 para. 1 FSCA), but examines only the arguments raised, unless any further legal deficiencies are obvious. In the appeal proceedings concerning the granting or refusal of monetary benefits from accident insurance, the Federal Supreme Court is not bound by the lower court's findings of fact relevant to the law (Art. 97 para. 2 and Art. 105 para. 3 FSCA). In this case, the question is whether the appellant was rightly obliged to provide insurance benefits to the respondent. At issue is the performance obligation of the appellant, as affirmed by the lower court, for the consequences of a complex meniscus tear at the medial posterior horn on the right and a third-degree cartilage damage with a large cartilage flap. The lower court concluded that the event of June 10, 2015, was not to be qualified as an accident in the legal sense because there was no damaging effect of an unusual external factor on the body of the insured. It remains to be examined whether the insured suffered an accident-like bodily injury in this incident. An obligation to perform on the part of the accident insurer exists only if the injury is due to a sudden, unintended damaging effect of an external factor. In the case of accident-like bodily injuries, the only element of the offense that is missing compared to actual accidents is the unusual nature of the external factor acting on the body. All other characteristics of an accident must, however, also be fulfilled in the case of accident-like bodily injuries. The lower court assumed that on June 10, 2015, the respondent, as a less practiced player in difficult terrain conditions, executed a mishit. Although this was not an unusual event, it was nevertheless an objectively verifiable, perceptible, and thus accident-like event occurring outside the body. The appellant pointed out that various descriptions of the course of the event exist and that the lower court had disregarded the evidentiary principle of the "statement of the first hour.\" In the overall consideration of the descriptions, it is noticeable that the course of the event of June 10, 2015 was described in increasingly detailed and serious terms, the more differentiated the insurance justified its rejection of the claim for benefits. Based on the case law on the "statements of the first hour,\" it is therefore necessary to refer to the description of the event in the accident report of June 17, 2015 and the form of June 25, 2015. Consequently, contrary to the lower court, it must be assumed that a normal, controlled tee shot in a slanted position was made during golf, which also included the twisting of the body and the right knee after the shot. The fact that such a tee shot involves a certain amount of force does…No accident-like bodily injury during golf
8C_325/2017
Accident Insurance (UV)