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I 2018 18 • VG SZ I 2018 18 KI-generiert

Insurance Claim Denial Over Rotator Cuff Rupture Causation

Geschäftsnummer I 2018 18
Gericht / Behörde
Rechtsordnung Schweiz · Kanton Schwyz (CH-SZ)
Entscheiddatum
Originalquelle öffnen Entscheidsuche-Spiegel Maschinenlesbares Markdown (.md)

Legislator-Zusammenfassung

KI-generiert

A claimant appealed a decision by an insurance entity concerning a claim for benefits related to a rotator cuff rupture sustained in an accident. The core of the dispute involved whether the injury constituted an insured event under accident insurance provisions. The court reasoned that while the claimant suffered a fall, the medical evidence, including expert opinions, did not establish a sufficient causal link between the fall and the subsequent rotator cuff rupture, concluding that the rupture was likely degenerative rather than traumatically caused by the accident, thereby upholding the denial of benefits.

Legislator-Regeste

KI-generiert

Insurance Claim Denial Over Rotator Cuff Rupture Causation: The core of the dispute involved whether the injury constituted an insured event under accident insurance provisions. The court reasoned that while the claimant suffered a fall, the medical evidence, including expert opinions, did not establish a sufficient causal link between the fall and the subsequent rotator cuff rupture, concluding that the rupture was likely degenerative rather than traumatically caused by the accident, thereby upholding the denial of benefits.

Schlagwörter

KI-generiert
Versicherungsleistungsbegehren Unfallkausalität medizinische Beweismittel Schulterverletzung Kausalzusammenhang Überversicherung
KI-generiert
I 2020 29
Insurance Benefits Appeal: Accident Causality of Rotator Cuff Tear
I 2020 52
Appeal of Denial of Accident Insurance Benefits for Arm Tear
I 2024 39
Appeal of Denial of Accident Insurance Benefits for Shoulder Injury
I 2022 16
Appeal Against Cessation of Accident Insurance Benefits Due to Disputed Causal Link for Shoulder Injury
I 2022 45
Accident Insurance Benefits Appeal: Causal Link in Shoulder Injury Claim

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Volltext

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\n\n| | | |\n I 2018 18 |\n |\n \n\n

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\n\n| | | |\n |\n Entscheid vom 12. November 2018 |\n \n\n

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\n\n| | | |\n Besetzung |\n Dr.iur. Vital Zehnder, Vizepräsident |\n \n|\n |\n Dr.med. Urs Gössi, Richter Dr.med. Pierre Lichtenhahn, Richter |\n \n|\n |\n MLaw Stefan Getzmann, Gerichtsschreiber |\n \n\n

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\n\n| | | |\n Parteien |\n A.________, \n Beschwerdeführer, \n vertreten durch Rechtsanwalt lic.iur. B.________, |\n \n|\n |\n gegen |\n \n|\n |\n Suva, Rechtsabteilung, Fluhmattstrasse 1, Postfach 4358, 6002 Luzern, \n Vorinstanz, |\n \n\n

\n \n \n \n \n \n

\n\n| | | |\n Gegenstand |\n Unfallversicherung (Leistungsanspruch bei Rotatorenmanschettenruptur) |\n \n\n

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Sachverhalt: