progetti
ATA/35/1997 ΓÇó Broken dental crown while eating chicken is not an accident
ATA/35/1997Corte di giustizia / Camera amministrativa15 gen 1997Dismissed
The insured person broke a dental crown on a bone while eating chicken and claimed accident insurance coverage for the resulting dental expenses. The court held that the event was not an accident within the meaning of Art. 9(1) OLAA because the extraordinary external factor was lacking. The appeal was therefore dismissed and no reimbursement of dental costs was ordered.
Art. 9 al. 1 OLAA; accident definition; extraordinary external factor: the mere breaking of a dental crown on a bone while eating does not constitute an accident, as the prerequisite of an extraordinary external factor is lacking. Ordinary mishaps in the course of eating are not sufficient to trigger accident insurance coverage for dental treatment costs.
Descripteurs
ASSURANCE SOCIALE; ACCIDENT; AA; AFFECTION DENTAIRE; CAUSE EXTERIEURE EXTRAORDINAIRE; REMBOURSEMENT DE FRAIS(ASSURANCE); ASSU
Normes
LAA.9 al.1
Résumé
Le fait de se briser une couronne dentaire sur un os en mangeant du poulet ne saurait être qualifié d'accident au sens de l'art. 9 al. 1 OLAA, la condition du facteur extérieur extraordinaire faisant défaut.