Terms and Conditions, Insurance for students and doctoral students at Swedish universities, Personal injury 2020

Terms and Conditions for The Swedish State´s Insurance for students and Ph. students at Swedish universities.

Dokumentinformation

Type of document: Terms and conditions

Valid: 2020-03-01

Sender: Insurance Department

Number of pages in print: 8


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1 Scope, definitions and deductible

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1.1 Background

The insurance is, in accordance with Chapter 1, Section 11a of the Higher Education Ordinance (1993:100) purchased from Kammarkollegiet by the Swedish Council for Higher Education (UHR) on behalf of the higher education institutions.

Policy holders are the state-owned Higher Education Institutions in accordance with Appendix 1 to the Higher Education Ordinance (1993:100) through UHR.

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1.2 Who is covered by the insurance?

The insurance covers all of the policy holders' students and doctoral students in accordance with the definitions found in Chapter 1, Section 4 of the Higher Education Ordinance (1993:100).

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1.3 When and where does the insurance policy apply?

The insurance applies in Sweden. It applies

  • during school hours and

  • during direct travel between the home and the place where the school hours are spent.

School hours refers to

  • all time spent in and around the higher education institution's premises, except when the stay there is due to activities of a leisurely character that are organised by someone other than the higher education institution,

  • all other time during which the student participates in activities organised by the higher education institution,

  1. remaining internship or other part of the education which, after approval by the higher education institution, is scheduled after the end of a semester assuming that the student is still admitted to and conducts studies.

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1.4 Definitions

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1.5 Accident

Accident refers to a bodily injury caused by an involuntary and sudden event involving external violence to the body.

Injury during scheduled physical exercise or health care practice or other practical tuition with a high level of physical strain is considered to be an accident even if the requirement for external violence is not met.

The effects of smoke, gas, chemical substances, heat, cold or radiation are considered to be equivalent to external violence. The same applies to changes in pressure and other effects on the body during the teaching of diving.

In spite of the requirement for an involuntary event, sudden events involving external violence to the body are also considered to be accidents if they arise in connection with work, education, practice or exercises that the insured participates in voluntarily, if the event is an undesired and unforeseen consequence of this. The same applies to injury or illness that arises in connection with practising injection or sample taking during health care teaching.

Repetitive strain or overload injuries, twisting injuries (except to the knee) and damage to teeth when chewing or biting are not counted as accidents. The same applies to heart attack, cerebral haemorrhage etc., as well as illness caused by bacteria, virus or other infection that did not arise in connection with a sudden and involuntary event involving external violence to the body.

Illness through infection

"Illness through infection" means the same thing as occupational injury through infection in Section 5 of the Ordinance (1977:284) concerning occupational injury insurance and state injury insurance.

Statutory base amount

“Statutory base amount” means the price base amount as defined in the Social Insurance Code.

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1.6 Deductible

The insurance has no deductible.

2 Insurance cover

In the event of personal injury due to accident or illness through infection suffered by the insured during the insurance period, compensation for personal injury is paid according to chapter 5 sections 1 and 2 of the Damages Act (1972:207) as if liability to pay damages had existed. In questions of compensation for loss of earnings, the rules on calculation of the basis for life annuity in chapter 41 sections 8-18 of the Social Insurance Regulations (2010:110) are applied.

Compensation for personal injury according to chapter 5 sections 1 and 2 of the Damages Act includes, among other things, health care costs, loss of income, pain and suffering and disfigurement or other permanent injury. Compensation according to point 2 of the above-mentioned act also covers funeral costs, loss of maintenance and personal injury for the next of kin of the deceased.

Personal injury in connection with assault is compensated to the extent that the insured does not, within a reasonable time in consideration of the nature of the injury and the need for compensation, receive damages from the perpetrator, the perpetrator’s insurance company or another, although no later than three years after Kammarkollegiet has been notified. If the insured has been negligent, compensation may be adjusted.

If the personal injury due to accident or illness through infection leads to death within three years of the event, one base amount is paid to the estate, in addition to any amount that has already been paid. If the deceased has children who have not reached 18 years of age at the time of death - in addition to compensation for loss of maintenance according to the first paragraph - compensation is paid of three base amounts to each such child and three base amounts to the other parent of such children as beneficiary of the accident insurance, provided that the other parent is, or in connection with the death becomes, a legal guardian.

Necessary and reasonable costs are reimbursed in the event of damage to teeth caused by an accident. For implant treatment and dental veneers, compensation is only paid on condition that the treatment is of such a kind as is covered by the general dental insurance. Before treatment is given the insured or the dentist giving treatment must contact Kammarkollegiet for an assessment of whether the treatment is reasonable. The insurance only provides compensation for permanent treatment. Damage caused by chewing or biting is not considered to be an accident and is not compensated under this point.

2.1 Instructions

Assault must be immediately reported to the police. The insured shall produce evidence that a police report has been made. If Kammarkollegiet so requires, the insured must bring a legal action for damages against the perpetrator Kammarkollegiet will then cover all the insured’s costs that are not otherwise covered.

The insured shall observe normal caution, i.e. if possible, avoid dangerous areas and situations and otherwise do what may reasonably be expected in order to avoid being the victim of assault or other injury. In the event of negligence, compensation is normally halved, unless the circumstances are such that the negligence was very minor or had little significance for the insurance claim. In the event of gross negligence, the right to compensation may be lost completely. The same applies if the insured was under the influence of alcohol, sleeping pills, narcotics or other intoxicant or committed a deliberate act that could lead to at least a fine under Swedish law.

2.2 Exceptions

The injury insurance in accordance with this insurance applies only to the extent a corresponding reimbursement cannot be paid in accordance with the private or government collective bargaining agreement concerning compensation for occupational injury (TFA or PSA), in accordance with the Motor Traffic Damage Act (1975:1410) or in accordance with regulations regarding responsibility for railroad or aviation operations or operation of a facility where injury liability is specifically regulated by law.

In case of injuries where there is a right to life annuity in accordance with the Social Insurance Code, the occupational injury annuity is coordinated with the reimbursement in accordance with this insurance. This insurance reimburses personal injury only to the extent that they cannot be compensated in accordance with the Social Insurance Code, other act or other insurance.

Reimbursement for personal injury in connection with assaults will be paid in the event that the student does not, within a period that is reasonable in view of the nature of the injury and the need for compensation, receive compensation from the assailant, the assailant’s insurance company or other source, although no later than three years after notification to Kammarkollegiet.

No benefit is paid under the policy for insult.

No benefit is paid under the policy if the injury is not documented in medical journals, certificates or the equivalent in the healthcare system.

3 3 Insurance claim

Insurance claims shall be submitted on a special form, which is found on Kammarkollegiet’s website www.kammarkollegiet.se. Claims shall be signed by both the insured and the authority. The person requesting reimbursement shall also do the following:

1. in the event of theft or assault, attach proof of reporting issued by the police in the place where the claim arose,

2. submit a specified claim for reimbursement and attach original receipts and other verifications. Amounts less than SEK 150 are not paid to a foreign bank account.

3. if other insurance applies for the same claim, advise Kammarkollegiet of this and

4. if Kammarkollegiet so requests, attach information and provide doctor’s certificates and other documents that Kammarkollegiet needs to adjust the claim, as well as assisting so that damaged property can be inspected.

5. if other insurance applies for the same claim or if reimbursement for the claim has been received from another source, advise Kammarkollegiet of this and,

4 4 General terms and conditions

4.1 4.1 Other insurance

Claims or costs only to the extent that these cannot be compensated through other insurance, regulations or laws.

4.2 4.2 Limitations period

The right to reimbursement will cease three years after the date of damage if a claim has not been received by Kammarkollegiet prior to such date. In other respects, general regulations regarding limitation periods apply.

4.3 4.3 Subrogation

To the extent Kammarkollegiet has paid reimbursement to the insured or beneficiary, Kammarkollegiet shall be subrogated the rights of such person against the party liable for the damage.

4.4 Register of insurance claims, GSR

The company has the right to use an industry wide register of insurance claims – the ”GSR” - to register loss claims under this policy.