ATA/603/1997•Adequate causality for post-accident somatoform and personality disorders
ATA/603/1997Tribunal de Justiça / Câmara Administrativa7 de out. de 1997Modified
Extraído pela Omnilex
The case concerned accident-insurance coverage after a road accident classified as at least of medium severity. The insured person suffered somatoform and borderline personality disorders. The court held that adequate causality between the accident and the later psychological conditions was established, so the insurer could not deny benefits on that ground.
Art. 6 al. 1 LAA; Art. 18 LAA; adequate causality of post-accident psychological disorders. Adequate causal connection must be assessed according to the gravity of the accident and the ordinary course of events. Where a traffic accident is classified as at least of medium severity, adequate causality may be admitted for ensuing somatoform disorders and borderline personality traits if the overall circumstances justify liability for the accident consequences.
Descripteurs
ASSURANCE SOCIALE; ACCIDENT; AA; CAUSALITE NATURELLE; CAUSALITE ADEQUATE; SYNDROME CERVICAL; AFFECTION PSYCHIQUE; INDEMNITE JOURNALIERE; MESURE DE READAPTATION(ASSURANCE SOCIALE); INVALIDITE(INFIRMITE); ASSU
Normes
LAA.6 al.1; LAA.18
Résumé
Causalité adéquate admise pour des troubles somatoformes et troubles de la personnalité de type borderline, consécutifs à un accident de la route qualifié "d'une gravité pour le moins moyenne" (collision). Causalité adéquate admise pour des troubles somatoformes et troubles de la personnalité de type borderline, consécutifs à un accident de la route qualifié "d'une gravité pour le moins moyenne" (collision).
Extraído pela Omnilex
Whether the post-accident psychological disorders are in adequate causal connection with the traffic accident.
Adequate causality was admitted.
The accident was qualified as at least of medium severity, which justified recognizing adequate causation for the ensuing somatoform and borderline personality disorders.
Whether accident-insurance benefits under the Accident Insurance Act must be granted in light of the established causal link.
The insured person's claim to benefits could not be denied on the ground of missing adequate causality.
Because adequate causation was established, the accident insurer remained liable in principle for benefits linked to the accident consequences.
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