The insurance terms give a clear definition for what counts as an accident, which means that the terms are fair and consistent for everyone. An accident occurs when an incident occurring suddenly and due to an external factor causes a physical injury against the insured party’s will. The definition can be specified with an example of slipping on ice.
An incident occurring suddenly means that the situation occurred quickly and without advance warning. Anyone who has ever slipped on ice knows that by the time you realise you are about to slip, it is often too late to correct your steps. The condition of suddenness is not met ife.g. your legs start to ache due to wearing bad shoes over a longer period of time, which means that the incident in question is not an accident.
In our example, the external factor is slippery ice. Another example of an external factor is a pothole on the street which causes you to lose your balance and fall down. However, if you have been suffering from a bad knee for a while and it dislocates easily by itself, there is no external factor in play, which means that the incident is not an accident.
Physical injury refers to all injuries from small cuts and sprains to broken bones and other injuries requiring more long-term treatment. The definition of an accident also helps clarify the difference between an accident and illness. Even though an illness, such as stomach flu or a cold, can start very suddenly, there is no sudden incident caused by an external factor behind that illness that would cause a physical injury.
The leisure-time accident insurance of the members of the Finnish Union of University Researchers and Teachers covers some of the treatment costs of accidents. These treatment costs can include e.g. doctor’s fees, application of a cast or x-ray examinations. The insurance also covers reasonable travel costs to the necessary treatment appointments.
The insurance also includes cover against permanent disability. Permanent disability can refer toe.g. an accident leading to permanent impaired function of an arm. In such cases, the reimbursement is based on the Finnish Government’s Classification of Impairments. For the most serious incidents, the members’ accident insurance also covers accidental death.
The insurance also covers part of the treatment costs of a sprain injury caused by a sudden movement or strenuous action. These include situations such as evasion of an opponent to avoid collision during a ball game which leads to a sprained leg, or lifting a heavy object and straining one’s back. In these incidents, the reimbursement of costs is more limited than in the case of accidents.
Remember that competitive sports and certain fields of sports or activities have been excluded from the accident insurance due to their high risks. If you are involved in such activities, consider taking out a separate sports insurance policy. Contact Turva for additional details. Check the insurance terms to see whether your sport is included in the insurance: turva.fi/tieteentekijat. The site also states the accident insurance policy’s maximum reimbursement sums and features more information about member benefits and insurance options.
Text: Turva / Tuomas Kekkonen