Return to all questions

Return to all questions

Are there foreign objects that were accepted or rejected as an accident according to the UVG?

March 14, 2025

Liability and Insurance Law

Open in Omnilex

In the Swiss Accident Insurance Act (UVG), there are several considerations and court rulings that deal with the recognition of health impairments as accidents. This distinction is important as it determines whether the insurance must provide benefits under the UVG or not.

According to Art. 6 para. 1 UVG, insurance benefits are granted for both occupational accidents as well as non-occupational accidents and occupational diseases (Art. 6 para. 1 UVG).

Specifically regarding bodily injuries, it is important under Art. 6 para. 2 UVG that these are not predominantly due to wear and tear or illness. Recognized injuries include, among others, fractures, dislocations of joints, meniscus tears, muscle tears, muscle strains, tendon ruptures, ligament injuries, and eardrum injuries (Art. 6 para. 2 UVG).

Moreover, case law establishes the presumption of liability for benefits according to Art. 6 para. 2 UVG. This means that the accident insurer is generally liable for benefits if the list diagnosis is met, unless it provides evidence that the bodily injury is predominantly due to wear and tear or illness (UV 2023/31).

Regarding foreign objects, there are also considerations. Art. 9 UVV makes it clear that non-accident-related damage to items that were used due to an illness and replace a body part or function do not constitute bodily injury within the meaning of the UVG (Art. 9 UVV).

The courts have applied this principle in various cases and confirmed that proof of predominantly wear and tear or illness-related causation can lead to a denial of liability for benefits (UV 2023/75).

A specific example that has been addressed by the case law is the case of an Achilles tendon rupture while skiing or during a sequence of jumps in long rope jumping, which have been recognized as accident-like bodily injuries, provided they are not predominantly due to wear and tear or illness (koordination.ch/de/online-handbuch/uvg/uks/uks-ab-01012017 5).

I hope this information helps you in classifying and assessing foreign objects in relation to accident insurance according to UVG. If you have specific cases, a more thorough investigation could be more targeted.

Sources

Federal Act of March 20, 1981 on Accident Insurance (UVG) > Second Title: Subject Matter of Insurance > General

Art. 6 para. 1 UVG

1 Unless this law provides otherwise, benefits are granted in the event of occupational accidents, non-occupational accidents, and occupational diseases.

Art. 6 para. 2 UVG

2 The insurance also provides its benefits for the following bodily injuries, provided they are not primarily due to wear and tear or illness: a. fractures; b. dislocations of joints; c. meniscus tears; d. muscle tears; e. muscle strains; f. tendon ruptures; g. ligament lesions; h. tympanic membrane injuries.

Art. 6 para. 3 UVG

3 The insurance also provides its benefits for damages inflicted on the insured during medical treatment (Art. 10).

Federal Act of March 20, 1981 on Accident Insurance (UVG) > Second Title: Subject Matter of Insurance > General

Art. 6 para. 1 UVG

1 Unless this law provides otherwise, benefits are granted in the event of occupational accidents, non-occupational accidents, and occupational diseases.

Art. 6 para. 2 UVG

2 The insurance also provides its benefits for the following bodily injuries, provided they are not primarily due to wear and tear or illness: a. fractures; b. dislocations of joints; c. meniscus tears; d. muscle tears; e. muscle strains; f. tendon ruptures; g. ligament lesions; h. tympanic membrane injuries.

Art. 6 para. 3 UVG

3 The insurance also provides its benefits for damages inflicted on the insured during medical treatment (Art. 10).

St. Gallen - Insurance Court - August 19, 2024

UV 2023/31

 a) Dislocations of joints (lit.  b) Meniscus tears (lit.  c) Muscle tears (lit.  d) Muscle strains (lit.  e) Tendon ruptures (lit.  f) Ligament lesions (lit.  g) and eardrum injuries (lit.  h). With Art. 6 Para. 2 lit. a to h UVG, the legal (causality) presumption is established that the accident insurer is liable to pay in the case of fulfilled list diagnosis. However, it can free itself from its obligation to pay if it proves that the bodily injury is predominantly due to wear and tear or illness (BGE 146 V 51; Message of May 30, 2008, BBl 2008 p.  5411, and additional message of September 19, 2014, BBl 2014 p.  7922; SZS 2017 p.  33; cf. BGE 122 V 157 E. 1b with numerous references; see also KOSS UVG-Nabold, N 53 to Art. 6 UVG; BSK UVG-Hofer, N 66 to Art. 6 UVG; Nabold, a.a.O., p. 84 ff.; Evalotta Samuelsson, New Regulation of accident-like bodily injury, The Example of the Meniscus Tear, in: SZS 2018, p. 357 f.). The health damage caused by an accident or a symptom pattern that arises can affect a previously intact or a previously pre-damaged body part. If the latter is the case, an accident-caused health damage or an accident-like bodily injury according to Art. 6 Para. 2 UVG is only considered as a temporary or determining aggravation of a pre-existing condition. The obligation to pay of the accident insurer in the case of an aggravated or only just manifested pre-existing condition ceases only when the accident no longer represents the natural or adequate cause of the health damage, i.e., when the latter is only and exclusively based on non-accident-related causes or the causality of a temporary aggravation (such as when activating a previously silent list injury) of an accident-like pre-existing condition can be excluded.

Summary

St. Gallen - Insurance Court - August 19, 2024

UV 2023/31

 a) Dislocations of joints (lit.  b) Meniscus tears (lit.  c) Muscle tears (lit.  d) Muscle strains (lit.  e) Tendon ruptures (lit.  f) Ligament lesions (lit.  g) and eardrum injuries (lit.  h). With Art. 6 Para. 2 lit. a to h UVG, the legal (causality) presumption is established that the accident insurer is liable to pay in the case of fulfilled list diagnosis. However, it can free itself from its obligation to pay if it proves that the bodily injury is predominantly due to wear and tear or illness (BGE 146 V 51; Message of May 30, 2008, BBl 2008 p.  5411, and additional message of September 19, 2014, BBl 2014 p.  7922; SZS 2017 p.  33; cf. BGE 122 V 157 E. 1b with numerous references; see also KOSS UVG-Nabold, N 53 to Art. 6 UVG; BSK UVG-Hofer, N 66 to Art. 6 UVG; Nabold, a.a.O., p. 84 ff.; Evalotta Samuelsson, New Regulation of accident-like bodily injury, The Example of the Meniscus Tear, in: SZS 2018, p. 357 f.). The health damage caused by an accident or a symptom pattern that arises can affect a previously intact or a previously pre-damaged body part. If the latter is the case, an accident-caused health damage or an accident-like bodily injury according to Art. 6 Para. 2 UVG is only considered as a temporary or determining aggravation of a pre-existing condition. The obligation to pay of the accident insurer in the case of an aggravated or only just manifested pre-existing condition ceases only when the accident no longer represents the natural or adequate cause of the health damage, i.e., when the latter is only and exclusively based on non-accident-related causes or the causality of a temporary aggravation (such as when activating a previously silent list injury) of an accident-like pre-existing condition can be excluded.

Summary

Regulation of December 20, 1982, on Accident Insurance (UVV) > Second Title: Subject of the Insurance > 1. Chapter: General Provisions > Accident-like Bodily Injuries

Art. 9 UVV

No bodily injury within the meaning of Article 6 paragraph 2 UVG constitutes non-accident-related damage to property that has been used due to an illness and replaces a body part or a bodily function.

Regulation of December 20, 1982, on Accident Insurance (UVV) > Second Title: Subject of the Insurance > 1. Chapter: General Provisions > Accident-like Bodily Injuries

Art. 9 UVV

No bodily injury within the meaning of Article 6 paragraph 2 UVG constitutes non-accident-related damage to property that has been used due to an illness and replaces a body part or a bodily function.


Next Question