| Summary: | An employee gets injured at work.
The insurance company refuses the benefit because the employee was not on her way to work.
The employee complains and wins.
The court notes that the violation occurred during working hours and in the course of the insured activity.
The insurance company must pay for the benefit.
Detailed summary:
The employee A. Z. is employed as a sterilization specialist at the company E. On October 20, 2018, she suffers an accident at work during working hours. She falls in the stairwell of the hospital where she works, injuring her knee.
The insurance company A. refuses the benefit because the employee was not on her way to work. At that time, she was on her way to another department of the hospital to attend further education there.
The employee is suing the insurance company. She argues that the violation occurred during working hours and within the framework of the insured activity. She was on her way to further training, which was required as part of her work as a sterilization specialist.
The court rules the employee right. It establishes that the injury occurred during working hours and within the framework of the insured activity. The insurance company must pay for the benefit.
More details:
Further training was necessary for the employee to update her qualifications.
The employee was on her way to further training when she fell.
The insurance company did not have a plausible justification for refusing the benefit.
Legal aspects:
Accident insurance coverage does not only cover accidents that occur on the way to work. It also includes accidents that occur during working hours and as part of the insured activity.
In this case, further training was necessary for the employee to update her qualifications. She was therefore on the road as part of her insured activity.
Critical appraisal:
The court's decision is understandable. The insurance company did not have a plausible justification for refusing the benefit. Accident insurance coverage should protect employees in cases where they injure themselves during working hours. |