The coronavirus and patient insurance

Is it possible to claim compensation under patient insurance for a coronavirus infection?

The coronavirus pandemic has no effect on the compensation criteria of patient insurance. The criteria are applied as normal during the pandemic, both for cases related to the coronavirus and for the treatment of other diseases and injuries.

Whether a case is compensable or not is determined by assessing whether the case meets at least one of the compensation criteria laid down in the Patient Injuries Act or the Patient Insurance Act. Notices for injury related to the coronavirus or the treatment of any other medical condition can always be filed. The Patient Insurance Centre will decide whether a case is a compensable patient injury based on its investigation.

Is the Patient Insurance Centre operating as normal during the pandemic?

The Patient Insurance Centre operates as normal during the pandemic. We have minimised physical contact to ensure the continuation of case handling, and most of our personnel currently work remotely, except for some employees with tasks relating to processing mail. Our claims handling process is completely electronic and functions as normal during a pandemic as well. Our phone services also operate as normal.

Meetings with expert physicians are currently held remotely, for example. Due to the coronavirus, some of our expert physicians are very busy in their everyday jobs as doctors, which can slow down the handling of some individual cases. However, this does not have any significant effect on our overall processing times.

Acquiring documents, such as patient records or statements from healthcare professionals, can take longer than usual during the pandemic. However, there is currently no significant delay in this either.

You can file a notice of injury from the safety of your home by using the electronic form. This is a good time to handle your patient injury case.

I had a surgery booked with a hospital, but it was cancelled due to the coronavirus. I have been in pain for longer than would have originally been necessary, and my state of health has deteriorated while waiting. Can I claim compensation under patient insurance?

The amount of resources available for healthcare affect the quality of care that a society can provide. Deterioration in health that is due to a lack of healthcare resources is not compensable under patient insurance, if the distribution of resources and operations of healthcare providers have otherwise been appropriate and the urgency for care has been assessed correctly.

You can file a notice of injury with the Patient Insurance Centre. We will investigate your case and assess whether the urgency for care has been assessed correctly when taking into account the resources that your healthcare provider has had available.

I was infected with the coronavirus at a care home. Can I claim compensation under patient insurance?

Only personal injuries occurring in connection to treatment provided by a healthcare professional are compensable under patient insurance. The primary purpose of elderly care services or home care services is to monitor, help, care for and support the customer, and these are not usually regarded as healthcare. A coronavirus infection contracted from the personnel or another resident of a care home does not occur in connection to healthcare, and thus does not fall under the scope of the Patient Injuries Act.

However, if proof exists that the infection happened in connection to medical treatment provided at the care home, the provision on infections of the Patient Injuries Act may be applicable. These cases can be investigated by the Patient Insurance Centre.

I was infected with the coronavirus at a hospital ward. Can I claim compensation under patient insurance?

Infections that are likely to have been contracted in connection to examinations or treatment are compensable under patient insurance if the infection is assessed to be an abnormal consequence of the treatment. In evaluating the compensability of a case, both the risks for leaving the condition untreated and the risks of the treatment itself are considered. The severity of the disease or condition being treated, and the level of infection risk associated with the treatment increase the required severity of the infection and the amount of damage caused by it for the infection be compensable.

Compensation under patient insurance can be claimed for an infection (incl. a coronavirus infection) contracted at a hospital ward. The compensability of the case will be assessed at the Patient Insurance Centre with an ‘infection tolerance evaluation’.

The submission of my documents for the Patient Insurance Centre will be delayed due to the coronavirus pandemic. What should I do?

If you need to submit documents that require, for example, a medical statement, to the Patient Insurance Centre, and you are unable to book an appointment with a physician or your appointment is delayed due to the coronavirus situation, please contact our customer service. In most cases, you can be granted an extension to your deadline.