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VakO 26.2.1985/2143:84 AI generated

Insurance court allowed partial compensation for knee injury when initial assessment missed internal ligament tear.

Case Number VakO 26.2.1985/2143:84
Court / Authority
Jurisdiction Finland (FI)
Decision Date
Outcome Partially Allowed
Open official source Machine-readable Markdown (.md)

Legislator summary

AI generated

The insurance court overturned the insurer's decision to deny coverage for a specific internal tear of the knee joint. The employee was initially compensated for a general muscle strain, but the insurer later rejected the claim for the specific ligament damage. The court ruled that the initial assessment was insufficient and mandated coverage for the missed injury.

Legislator headnote

AI generated

Insurance Act; Personal Accident Insurance Act: When an initial medical assessment fails to identify a specific, compensable injury like an internal ligament tear, the insurer cannot deny coverage for that specific damage based on the incomplete initial report.

Keywords

AI generated
personal accident insurance medical assessment insufficiency ligament tear coverage insurer liability compensation denial
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Insurance court dismissed claim for shoulder inflammation compensation when injury was deemed unrelated to work accident.
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Court allows partial compensation for shoulder injury where accident aggravated pre-existing arthritis and caused partial rotator cuff tear.
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Full text

Työntekijä oli kantaessaan puutavaraa astunut kiven päälle ja kaatunut, jolloin oikea polvi oli vääntynyt. Tapaturma oli korvattu oikean polven venähdysvammana. VAKO kumosi tapaturmalautakunnan päätöksen, jossa myös polven sisemmän nivelkierukan repeämä oli määrätty korvattavaksi. I-jaosto KKO 18.9.1986 kumosi VAKO:n päätöksen ja määräsi nivelkierukan repeämän korvattavaksi. (Lääkintöhallitus: Slätis-Tervo)