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  #61  
Old 03.12.2022, 17:37
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Re: When is an accident not an accident?

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@ Reycobos - why did you post on here, as you already believe you know better than anyone else (as in most of your other problems here). Go waste someone else’s time.

Not our problem.


Sorry if you dislike my answers, I replied to you because you've asked me some questions and I didn't want to be unpolite and not replying your questions. I didn't know you didn't expect an answer...

I knew the basics before first posting here, in fact the last post by pelfe and aSwissInTheUS help me a lot to clarify some stuff and to find more information. I tried to keep clean the forum and I normally ask something on an already opened thread if I've got the chance.

I don't feel you've wasted your time but anyway, thanks.
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  #62  
Old 03.12.2022, 17:45
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Re: When is an accident not an accident?

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Sorry if you dislike my answers, I replied to you because you've asked me some questions and I didn't want to be unpolite and not replying your questions. I didn't know you didn't expect an answer...

I knew the basics before first posting here, in fact the last post by pelfe and aSwissInTheUS help me a lot to clarify some stuff and to find more information. I tried to keep clean the forum and I normally ask something on an already opened thread if I've got the chance.

I don't feel you've wasted your time but anyway, thanks.
Not a problem, but there are many posters that post inaccurate information on their issue, and they have the Forum in dissent, as has already occurred here. Your past posting history is available to all, and it would be preferable if you would provide all details before posting, especially when disputing a petty amount.

Otherwise, your post has been very interesting. However it does appear that you knew the answer before posting.
That should have been in your opening post, to gain validation.
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  #63  
Old 03.12.2022, 17:55
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Re: When is an accident not an accident?

I've got it.
If I need to ask something next time, I'll write down with more details.
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  #64  
Old 14.01.2023, 12:04
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Re: When is an accident not an accident?

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Because sprained ankles are always accidents under law. We quoted the relevant law and they paid up.
My case: meniscus/ligament tear from sport, Suva'd paid all doctor visits but denied to cover the cost of surgery and further benefits two weeks after the surgery. They claimed it's not accident related..

Suva sent me an official letter (Verfügung) on 20 Dec 2022. I need make an appeal by 20 Jan 2023 (I believe).

I wonder if I can write the appeal letter myself or it has to be done by a lawyer. How did you do it?

Thanks in advance!
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  #65  
Old 13.02.2023, 02:11
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Re: When is an accident not an accident?

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My case: meniscus/ligament tear from sport, Suva'd paid all doctor visits but denied to cover the cost of surgery and further benefits two weeks after the surgery. They claimed it's not accident related..

Suva sent me an official letter (Verfügung) on 20 Dec 2022. I need make an appeal by 20 Jan 2023 (I believe).

I wonder if I can write the appeal letter myself or it has to be done by a lawyer. How did you do it?

Thanks in advance!
What sport? Base jumping for example is not covered...If you did something considered as risky it won't be covered.
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  #66  
Old 13.02.2023, 10:17
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Re: When is an accident not an accident?

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My case: meniscus/ligament tear from sport, Suva'd paid all doctor visits but denied to cover the cost of surgery and further benefits two weeks after the surgery. They claimed it's not accident related..

Suva sent me an official letter (Verfügung) on 20 Dec 2022. I need make an appeal by 20 Jan 2023 (I believe).

I wonder if I can write the appeal letter myself or it has to be done by a lawyer. How did you do it?

Thanks in advance!
As I said earlier:

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So we wrote to the claim handler, quoting the relevant laws, and the decision has been reversed. It was an accident and SUVA cover the lot.

The bill we got from our health insurance has been cancelled.

Many thanks for all the help.
In our particular case it is in the legislation that that specific injury is always an accident, so we didn't need a lawyer.
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  #67  
Old 13.02.2023, 11:07
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Re: When is an accident not an accident?

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What sport? Base jumping for example is not covered...If you did something considered as risky it won't be covered.
SUVA said it is not an accident.

An accident due to a hazardous activity (Wagnis) is still an accident. Which is worse, as neither health insurance would pay. However, if SUVA says it is not an accident, then its an illness and health insurance must cover the usual cost. As SUVA is usually basic coverage only, there is usually not much financial risk. Different if you have full private coverage for accident, but only basic coverage for illness. There you could be suddenly faced with huge, non covered, hospital bills.
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