Questão jurídica principal
Whether the insured violated the duty to mitigate damage under Art. 21(4) ATSG by not undertaking the ordered rehabilitation.
Decisão extraída
The file did not allow a finding that the insured had sufficiently engaged with the prescribed measure; the absence of timely action could be sanctioned, but further factual elements still had to be examined.
Fundamentação extraída
The Court held that the letter of 3 June 2005 was addressed to the insured himself and did not permit him to simply wait for the doctor to act. However, the appellate court had not yet examined all prerequisites for sanctioning under Art. 21(4) ATSG, including suitability, causal link, and proportionality.