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KKO 1630/2013 Generato dall'IA

Supreme Court allows insurance company to deny accident benefits after new medical evidence shows injury occurred post-policy period.

Numero d'incarto KKO 1630/2013
Autorità giudiziaria
Giurisdizione Finlandia (FI)
Data della decisione
Esito del giudizio Accolto (Allowed)
Apri la fonte ufficiale Versione Markdown leggibile dalle macchine (.md)

Sintesi Legislator

Generato dall'IA

The Supreme Court of Finland allowed the insurance company's decision to deny accident benefits to the claimant. The claimant suffered a neck injury in a traffic accident in July 2009, but the insurer initially denied coverage for injuries occurring after November 2009. Upon receiving new medical and expert reports, the court determined the injury timeline supported the insurer's position, leading to the reinstatement of the denial.

Regesto Legislator

Generato dall'IA

Accident Compensation Act; Insurance Law: The court held that if new medical evidence confirms an injury occurred after the policy period, the insurer is entitled to deny benefits under the relevant insurance legislation.

Parole chiave

Generato dall'IA
accident compensation insurance coverage denial medical evidence timeline policy period exclusion traffic accident injury modifica sostanziale dello stato di salute perizia medica aggiornata trattamento ambulatoriale

Disposizioni normative citate

Generato dall'IA
Accident Compensation Act
Insurance Law
Generato dall'IA
insurance_2008_6887-2007
Insurance court dismissed late appeal due to missing electronic submission notice, ruling the appeal inadmissible despite valid complaint form.
kko-precedent_1997_163
Supreme Court dismisses claim where whiplash injury causation is medically possible but not definitively proven by expert evidence.
admin_2008_helsinki__424
Administrative court dismissed increased traffic insurance surcharge due to erroneous collection after ownership transfer.
insurance_1981_5318-1980
Insurance court dismissed pension claim adjustment due to lack of new medical evidence proving disability onset.
kko-precedent_2011_69
Supreme Court allows accident compensation for depression and limb symptoms caused by long-term neck pain following a traffic accident.

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Testo completo

A oli 2.7.2009 ollut liikenneonnettomuudessa, jossa hänen niskansa oli venähtänyt. Vakuutusoikeus oli katsonut, ettei A:lla ollut oikeutta tapaturmavakuutuslain mukaisiin korvauksiin 30.11.2009 jälkeen. Korkeimmalle oikeudelle esitetyn uuden lääketieteellisen ja muun selvityksen johdosta asia palautettiin vakuutusoikeudelle uudelleen käsiteltäväksi.