Patient insurance will only cover the extra costs and losses caused by the patient injury. Costs and losses that would have been incurred regardless of the patient injury will not be compensated.
Consequently, compensation cannot be awarded for medical expenses incurred by the original treatment or examination of the patient’s illness or injury. Therefore, when assessing the amount of compensation payable, the costs and financial losses due to an underlying condition or previous injury and those incurred by the patient injury must always be separated.
Compensation is claimed using a separate form available for the purpose when you have received a favourable claims decision.
Compensation payable under Patient Insurance is determined by applying the provisions of the Tort Liability Act and the guidelines issued by the Traffic and Patient Accident Board. The decision policy of the Traffic and Patient Accident Board will also be taken into account in the compensation. As a rule, costs and losses arising from the injury will be compensated for in full. However, the injured party is also expected to prevent any subsequent loss whenever possible. The costs incurred must be necessary with regard to the treatment of patient injuries.
The amount of compensation and the way it is calculated are determined by the guidelines issued by the Traffic and Patient Accident Board.
The patient insurance system functions as a secondary compensation system with respect to the general social security system. The amount of compensation and benefits paid in accordance with other acts, such as benefits paid by Kela in accordance with the Health Insurance Act, sickness allowance, national pension and guaranteed pension, will be deducted from the compensation payable for the patient injury. However, with respect to employment pension, the patient insurance system is the primary payer.