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[Statutory accident insurance--obligatory social accident insurance in Switzerland].

According to the new Accident Insurance Law, in Switzerland it is mandatory for all employees to be insured against accidents and occupational diseases. The legal bases, organization and implementation of this mandatory social accident insurance are described. Discussed in particular are the specific Swiss features, such as the inclusion of non-occupational accidents (leisure-time accidents), and special medical aspects in the assessment of incapacity, injury and occupational diseases.

Accidents, Occupational

[Differentiation of "accident" and "accident sequelae" in private accident insurance].

In legal and private accident insurance you can find a distinction between "accident" and "results of an accident". In the system of the AUB (general terms of accident insurance) the insurant's injury is a notional part of the accident, which has been criticized by some medical experts. In fact, this distinction could entail different meanings and interpretations of the term "results of an accident", especially in section 10.1 AUB. In the author's point of view, section 10.1 AUB is applicable whenever different factors due and not due to the accident combine to produce the injury or the further damage (e.g. death, disablement).

Disability Evaluation

[Private accident insurance in Switzerland with reference to liability insurance as a part of social security].

On the Swiss market there exist various different accident insurance schemes and systems. Private accident insurance which is offered by the private insurers, date back to the middle of the 19th century. Since 1912 accident insurance is compulsory for all employees working in particularly dangerous industries, since 1984 it covers all employees in the country. In Switzerland there exists no general compulsory accident insurance. To perform as insurance carriers are qualified: private insurance companies, the Swiss Accident Insurance Company, and a number of the social health (sickness) insurers. Depending on the insurance system there are different approaches to renumerate the health costs. In the various social insurance systems the patient is rather free to chose his doctor and hospital (among those who have a contract with the insurer); in private insurance he is completely free. Yet the billing systems and the applicable rates and tarifs differ considerably. There are trends to simplify these systems and bring them more into mutual accordance. Due to the important rise of the health costs in Switzerland, there exists the danger that possible simplifications will bring about more public influence yet less private initiative and less incentives to really control costs without lessening the patients' possibilities.

Humans

[Group occupational medicine of the Swiss Accident Insurance Institute ].

According to the Swiss Federal Accident Insurance Law, the Swiss National Accident Insurance Company (Suva) is responsible for the prevention of occupational disease in all Swiss industries. In the Suva medical division, a special group concerned with occupational medicine ensures that these measures are implemented. It first of all organizes and supervises preliminary check-ups and follow-up examinations and then may also exclude endangered employees from their present activity. Such employees are entitled to free advice and in certain cases may qualify for interim daily allowances.

Air Pollutants, Occupational

[Development of loss-of-limb coverage in private accident insurance].

The oldest known private accident insurance is recorded in the maritime law of Wisby of 1541. Defoe is the first to propose a compensation scale for loss of limbs in the 17th century. It is taken over in a modified character by all insurance companies being founded in Europe and North America since 1850. The structure of the present insurance conditions originates in the conditions of 1920. Since then the loss of the right and left upper limb is rated equally. The compensation scale is changed again in 1961, the loss of extremities is valued higher and the loss of sense of smelling and tasting is considered.

Persons with Disabilities

[Evaluation of suicide in legal accident insurance and private insurance].

The thesis, that suicides are chiefly understood to be terminal stage developments and indemnified through compliance with prerequisites of the insurance law norm, is critically explained with regard to the scientific-theoretical evolution. Recent interdisciplinary investigations (epidemiology, statistics, sociology, psychology, psychiatry) as well as the changing approach of a large section of the population towards suicidal behaviour (self-determination and the responsibility of the individual, human dignity, breaking away from handed down moral judgements) show that the estimation held with cogency in many quarters with respect to suicide as being a reliable symptom of a disease, cannot be maintained. This result is further supported by the record number of individuals, within the sphere of the private insurance, finding themselves in financial and political "marginal situations" (class and social problems, material safeguard for families and the like) and committing suicide after reasonably pondering their dilemma; a condition which in many aspects comes close to "balance suicide". From an insurance medical angle the relevant statutory provisions and the supreme court jurisdiction of the last years are put forward to the medical experts with the requirements derived hereunder.

Expert Testimony

[Assessment of eye damage in private accident insurance in Austria].

In Austria, eye damage is assessed by private accident insurance underwriters in accordance with the "General Rules for Private Accident Insurance" (AUVB 1965). According to these rules the degree of invalidity is determined on the basis of three types of findings: 100% in the case of total loss of vision, 30% in the case of total loss of vision in one eye, and 60% if vision in the other eye had already been lost. In the case of complete loss of vision in one eye and simultaneous partial loss in the other, or partial deterioration of vision in both eyes, the basis for calculating the degree of invalidity is 50% for each eye. The respective degrees of disability are expressed in thirtieths. The degrees of disability are adjusted to the levels of reduction in earning capacity in accordance with the proposals of the German Ophthalmological Society, which are also recommended in Austria. The difference in the degree of disability according to the AUVB in Austria and the AUB in the Federal Republic of Germany, resulting from different methods of calculation, is pointed out. The degrees of disability for accidental damage to one or both eyes (without previous damage) are presented in tabular form. As regards visual field defects, the degree of disability should be assessed on the basis of the total visual field, taking into account the fact that the eyes are paired sensory organs.

Austria