Is it worthwhile for me to file an injury notification?
You must decide for yourself whether you want to file an injury notification and apply for compensation for a suspected injury. You can receive help for your decision-making through discussions with the healthcare provider responsible for the treatment or a Patient Ombudsman. The Patient Insurance Centre will decide whether your injury is compensable under Patient Insurance.
You can start the process by submitting your injury notification to the Centre. If you need help with the completing the injury notification, you may contact the Patient Ombudsman of the treating institution.
Is it possible to find out over the phone whether my injury is compensable?
You cannot get a decision over the phone. No two bodily injuries are completely identical, and therefore the Patient Insurance Centre cannot predict any decision on the basis of general enquiries.
It is important to be aware that not all harmful consequences caused in connection with treatment are compensated for. Similarly, there are no grounds for compensation in a case where the result of treatment does not fulfil individual expectations. About one third of claims receive compensation.
Is there a time limit for filing an injury notification?
Yes. According to the Patient Injuries Act, a claim must be filed within three years of the time the injured party knew or should have known of the injury. The time limit is never extended on the grounds that the claimant was not aware of patient injuries legislation or patient insurance.
Compensation can be claimed later under exceptional circumstances. However, a claim must be made no later than ten or twenty years from the time of the incident that led to the injury or the right to compensation is forfeited.
How long does it take for the Patient Insurance Centre to process my injury notification?
At present, a decision is made on half of the injury notifications within six months and over 95 % within a year. There are about 8,000 new injury notifications each year.
The processing time can vary considerably from case to case. At the early stages of the claims process, it is not possible to accurately assess how long the processing will take.
For cases that are medically or legally demanding, and which encompass several medical fields, the processing usually takes longer than average. The time it takes to obtain medical documents from the treating institutions also affects the overall processing time.
My wrist was fractured in an industrial accident and later I received a patient injury in connection with the treatment of the fracture. What are my options?
File an injury notification for the industrial accident under your employer's accident insurance. If you also claim under Patient Insurance, send your injury notification to the Patient Insurance Centre.
When the notification is received by the Patient Insurance Centre, claims made under accident insurance have usually been decided on and the claimant will have received all the due benefits. These benefits, as well as other statutory compensation, will be deducted from the compensation payable under Patient Insurance (coordination of compensation). The Patient Insurance Centre will pay any difference.
The provisions under different insurance schemes are not equivalent: for example, compensation for temporary incapacity (pain and suffering) can be awarded under Patient Insurance but not under Accident Insurance.
Is there a limitation period for financial claims, or filing a claim?
Yes. Deliver your claim for compensation to the Finnish Patient Insurance Centre no later than three years after you have received a positive compensation decision. If you are repeatedly compensated for various costs and losses, deliver your claim no later than three years after the loss has occurred.
How is compensation for pain and suffering determined?
The term "pain and suffering" was changed to "temporary incapacity" at the beginning of 2006. Compensation for temporary incapacity during the acute phase is included in the types of compensation payable under patient insurance. When deciding on the amount of compensation for temporary incapacity, the following criteria will be taken into account: the quality and degree of severity of the bodily injury sustained by the patient, the quality and degree of severity of the required treatment, and the time period of the disablement.
The amount of compensation is assessed according to the information available in case histories and other documentation. During determination, the norms and guidelines of the Traffic Accident Board are used as assistance, according to which in 2015, for example,
I received a lump sum settlement for permanent incapacity according to Disability Class 3. What does this mean?
Compensation for permanent incapacity is awarded to compensate for permanent functional incapacity. The incapacity may be manifested, for example, as weakened arm or leg functions. The term often used is 'disability'.
You may receive compensation under patient insurance only for additional incapacity that is due to the patient injury. If the patient's other illnesses or injuries are the cause of the incapacity, this cannot be compensated for. Compensation for permanent incapacity must be handled separately from compensation for loss of income. If the patient injury results in occupational disability and loss of income, the right to compensation for loss of income will be decided upon separately. Occupational disability does not affect the compensation paid for permanent incapacity.
The degree of permanent incapacity is determined in accordance with the Decision of the Finnish Ministry of Social Affairs and Health (1012/1986) or the Decree (1649/2009). In it, the injuries and illnesses have been divided in classes 20–1 according to the severity category with class 20 indicating the most severe incapacity and class 1 the least severe incapacity.
Examples: Complete paralysis of the ulnar nerve in the better arm and the resulting incapacity falls under Class 5, while complete peroneal nerve paralysis falls under Class 3 and moderate circulatory insufficiency under Classes 6–10.
How is the amount of compensation paid for permanent incapacity determined?
The amount of compensation will be based on the norms and guidelines of the Traffic Accident Board that are generally applied when determining compensation for bodily injury. Compensation for each incapacity category is determined annually. In addition to incapacity, the age of the injured party affects the final compensation amount.
Why does the age of the injured party affect the compensation for permanent incapacity?
The purpose of the compensation for permanent incapacity is to compensate for the repercussions of a personal injury which will affect the injured party for the rest of his or her life.
A person who has received a permanent incapacity at a younger age is more likely to suffer from the injury longer than an older person. For this reason, a younger person is paid higher compensation for a permanent incapacity than an older person who has received a similar injury.
A cosmetic incapacity, such as excessive, deforming scarring, may entitle a person to compensation on the grounds of permanent cosmetic incapacity. The amount of this compensation is dependent on the age at which the injury is received.
What is the time limit for legal proceedings?
Legal action must be taken at court, in other words within three years of the claims decision. Under penalty of forfeiture of the underlying right, an action against Finnish Patient Insurance Centre must be taken within three years of the date on which the claimant has been informed of the decision and the time limit in writing.
What is the time limit for bringing the matter to the Patient Injuries Board?
In the same time as legal action must be taken at court, in other words within three years. The Board has adopted a practice of considering requests where the patient has lost the right of bringing the matter to court within the statutory three years as being effectively unfounded.
This means that, in practice, the Board has not considered requests where the patient no longer has an opportunity to bring the matter to court. The decision on processing the matter at the Board is made by the Board.