Accident insurance: case remitted for new expertise

ATA/222/1997Tribunal de Justiça / Câmara Administrativa8 de abr. de 1997Remanded

Extraído pela Omnilex

Resumo Omnilex

In an accident-insurance dispute, the court sent the file back to the insurer. It held that further clarification was required, namely a new expert assessment and an economic inquiry to determine any possible loss of earnings of the insured person. The decision is a remand for additional fact-finding rather than a final merits ruling.

Sumário Omnilex

Art. 6 LAA; remand for further evidentiary clarification in accident insurance proceedings. Where the factual basis does not permit a reliable assessment of the insured person's entitlement, the decision-maker may remit the file for supplementary expert evidence and, if relevant, an economic investigation to determine the existence and extent of any loss of earnings. A remand is justified when the decisive facts are not sufficiently established for a final substantive determination.

Texto completo

Descripteurs

ASSURANCE SOCIALE; ACCIDENT; AA; EXPERTISE; DECISION DE RENVOI; ASSU

Normes

LAA.6

Résumé

Renvoi du dossier à l'assurance pour nouvelle expertise et calcul de l'éventuelle perte de gain de l'assuré (enquête économique).

Palavras-chave

social insuranceaccidentexpertiseremandloss of earningseconomic assessment

Extraído pela Omnilex

Questões jurídicas principais extraídas pela Omnilex

Questão jurídica principal

Whether the file must be remitted for a new expert assessment and an economic calculation of the insured person's possible loss of earnings.

Decisão extraída

The file is remitted to the insurer so that it conducts a new expertise and determines any loss of earnings through an economic inquiry.

Fundamentação extraída

The available assessment was insufficient to finally determine the insured person's entitlement; further clarification was required before a substantive decision could be made.

Accident insurance: case remitted for new expertiseGerado por IA