ATA/593/1996•Adequate causation denied for post-accident psychiatric treatment
ATA/593/1996Court of Justice / Administrative ChamberOct 15, 1996Dismissed
Extracted by Omnilex
The insured suffered a fall in a staircase accompanied by circumstantial amnesia and later claimed reimbursement from the accident insurer for treatment of psychological disorders. The court held that the accident did not establish an adequate causal link for those psychiatric complaints and therefore did not obligate the insurer to bear the treatment costs.
Art. 6 para. 1 LAA; adequate causation of psychiatric sequelae after an accident. A fall in a staircase, even if followed by circumstantial amnesia, does not by itself establish an adequate causal link between the accident and later psychological disorders. For accident insurance benefits, the decisive question is whether the accident is, in legal terms, suitable to cause the claimed psychiatric impairment; where this threshold is not met, the insurer is not obliged to assume treatment costs for such disorders.
Descripteurs
ASSURANCE SOCIALE; ACCIDENT; AA; TRAUMATISME CRANIO-CEREBRAL; TRAUMATISME CERVICAL; LESION DE LA COLONNE VERTEBRALE; DEPRESSION; CAUSALITE ADEQUATE; ASSU
Normes
LAA.6 al.1
Résumé
Une chute dans un escalier, suivie d'une amnésie circonstancielle, ne constitue pas un lien de causalité adéquat suffisant pour exiger le remboursement des frais de traitement de troubles psychiques par la caisse d'assurance-accident.
Extracted by Omnilex
Whether the stair fall and ensuing amnesia established adequate causation for psychiatric treatment costs under accident insurance law.
No adequate causal link was sufficient to require reimbursement of treatment costs for the psychological disorders.
The accident circumstances were not enough to attribute the psychiatric complaints to the accident in a legally adequate way.
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