A negative decision means that the patient injury reported to the Patient Insurance Centre does not meet the preconditions for the application of the Patient Injuries Act. Not all adverse events that occur in connection with medical treatment and health care are compensated for, only bodily injuries that fulfil the conditions prescribed in the Patient Injuries Act.
The negative decision is sent to the claimant, the insured healthcare professional or treating institution, and to the policyholder. The claimant will also be notified in writing if the claim cannot be processed owing to the expiry of the limitation period or some other reason.
The following injuries are not compensable under the Patient Injuries Act:
- Injuries that occurred outside the geographical area of Finland, even if the patient was referred for treatment abroad from Finland. This will be changed with legislative amendments that will apply to patient injuries occurring on or after 1 January 2021. Patient insurance 2021
- Material damage, such as torn clothing or the loss of dentures. In these instances, the claimant may claim damages from the tortfeasor under the Tort Liability Act.
- Patient insurance does not cover purely financial losses. Purely financial losses are economic losses that do not include bodily injuries or material damage. For example, if a customer is denied social benefits due to an assessment or a statement from a healthcare professional, the customer suffers a purely financial loss.
- Injuries occurring during the provision of ordinary domestic help, such as domestic help services or residential home services, that are not regarded as medical treatment and health care. In addition, help services and monitoring connected to living in a residential care home in ‘home-like’ conditions are not covered by patient insurance.
- Insignificant injuries, even if they qualify for compensation on other grounds. An injury is considered insignificant if it causes the patient only slight pain and suffering, no permanent functional disability, no aesthetic injury, or the costs incurred do not exceed €200.