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, 2 and 5 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.