Cessation of daily allowances under accident insurance

ATA/316/1996Court of Justice / Administrative ChamberMay 29, 1996Dismissed

Extracted by Omnilex

Omnilex summary

The appellant in an accident-insurance dispute failed to show that moving from a 50% to a 100% workload would be an insurmountable effort. The court therefore rejected the appeal and confirmed the cessation of daily allowance benefits under Art. 16(1) LAA.

Omnilex headnote

Art. 16 al. 1 LAA; cessation of daily allowances after improvement of work capacity. A claimant who disputes the termination of daily benefits must demonstrate, with substantiated arguments, that the increase in work capacity cannot reasonably be expected because it would constitute an insurmountable effort. Mere assertion of difficulty is insufficient; absent such proof, the insurer’s cessation of daily allowances is upheld.

Full text

Descripteurs

ASSURANCE SOCIALE; ACCIDENT; AA; DOULEUR DE LA TETE; INDEMNITE JOURNALIERE; ASSU

Normes

LAA.16 al.1

Résumé

Le recourant ne démontre pas que l'augementation de son temps de travail de 50 à 100 % représenterait un effort insurmontable. Rejet du recours, confirmtion de la cessation du versement des indemnités journalières.

Keywords

social insuranceaccident insurancedaily allowanceswork capacitycessationburden of proof

Extracted by Omnilex

Key legal questions extracted by Omnilex

Key legal question

Whether the appellant proved that increasing work activity from 50% to 100% would be an insurmountable effort, so that daily allowances had to continue under Art. 16(1) LAA.

Extracted holding

The appellant did not show that the increase to full work capacity would be an insurmountable effort; the cessation of daily allowances was therefore upheld.

Extracted reasoning

The court found the appellant’s submissions insufficient to establish continued incapacity or a medical/economic obstacle preventing return to 100% work capacity.

Cessation of daily allowances under accident insuranceAI generated