Insurance court rules travel costs reimbursed based on nearest facility, not private sector availability at home.
Legislator summary
AI generatedThe Insurance Court ruled that travel expenses must be reimbursed based on the cost to the nearest research and treatment facility. The insured argued for coverage of a private sector treatment available at their home location, which was further away than the public health center. The court determined that since the required care was not available at the home health center, traveling to the nearest facility was necessary, thereby validating the claim for the distance to that facility.
Legislator headnote
AI generatedInsurance Act s. 10; Travel costs are reimbursed based on the cost to the nearest research and treatment facility, not the cost to a private sector facility available at the insured's home location.
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Vakuutetulle aiheutuneet matkakustannukset korvataan sen mukaan, kuinka paljon matka olisi maksanut lähimpään tutkimus- ja hoitopaikkaan. Kyseistä hoitoa ei ollut vakuutetun kotipaikkakunnalla saatavissa terveyskeskuksesta. Koska hoitoa oli saatavissa yksityiseltä sektorilta vakuutetun kotipaikkakunnalla, ei matkaa kauemmaksi voitu pitää tarpeellisena.
Rättsfallsreferat på svenska (http://www.oikeus.fi/vakuutusoikeus/54252.htm)