Accident insurance for work abroad

Insurance Terms and Conditions in accordance with section 204 of the Finnish Workers’ Compensation Act

1 Conditions for being Granted the Insurance

1.1

Employees working abroad who are not required to be insured under section 3 of the Finnish Workers’ Compensation Act, can be insured against work-related accidents and occupational diseases in accordance with these terms and conditions. Only a Finnish company can be the policyholder.

1.2

The employer can take out voluntary occupational insurance for employees for whom the employer can arrange pension cover on the basis of the legislation mentioned in section 150, paragraphs 2–4 of the Employees Pensions Act.

1.3

The insurance takes effect as of the date when Fennia has verifiably received the insurance application, unless a later starting date has been agreed on.

1.4

The insurance is not granted for professional sports. Professional athletes must be insured separately under the act on accident insurance and pension provision for athletes (276/2009).

2 Persons Covered by the Insurance

2.1

The insured persons are persons mentioned by name in the policy document.

3 Scope of the Insurance

3.1

The insurance is valid only during working hours.

3.2

The insurance is valid outside of Finland.

4 Earnings as the Basis for Insurance Premiums and Compensation

4.1

The insurance contribution is determined on the basis of the salary/wages that the employer pays to the employee and the level of risk inherent in the work.

4.2

Daily allowance as referred to in section 58 of the Workers’ Compensation Act, paid on the basis of the insurance, is determined exclusively on the basis of the sick pay paid by the employer who took out the insurance or the earnings received while employed by said employer.

4.3

The insurance premium is determined annually in compliance with Fennia’s premium bases valid at the time. The premium bases have been drawn up, based on the stipulations of the Workers’ Compensation Act, separately for compulsory insurance, voluntary occupational accident insurance and off-working-hours insurance.

In accordance with Fennia’s premium bases, at least a minimum insurance premium for each calendar year is always charged on voluntary occupational accident insurance for as long as the insurance is valid.

5 The Policyholder's Disclosure Obligation

5.1

The policyholder has the obligation to notify Fennia of all the necessary information pertaining to the insurance when taking out the insurance.

5.2

The policyholder must report to Fennia any changes that take place while the insurance is valid without delay; however, no later than one month after the change takes place.

If such notice is made later than the aforementioned time limit, the change will enter into effect on the date when the notice of change was reported.

5.3

The injured person shall, without delay, inform Fennia of changes affecting the compensation such as significant changes in his/her state of health, work ability, work or earnings.

5.4

When an insured event takes place, Fennia must be notified in writing at the latest 30 days from when the incident occurred.

6 Insured Events and Restrictions

6.1

The insurance covers a work-related accident that happened to the employee at work, in the area where work is carried out or outside the area where work is carried out, in accordance with Sections 21–25 of the Workers’ Compensation Act.

6.2

Accident refers to a sudden and unexpected event resulting from an external factor that causes injury or illness to the employee.

6.3

The insurance also covers other injuries and illnesses caused by an accident, such as skin abrasions caused by chafing (Workers’ Compensation Act, section 18) and the significant worsening of an injury or illness caused by the accident. The worsening of an injury or illness is not compensated if the accident only played a minor part in its worsening. A maximum of six months of compensation, starting from the time of the accident, is paid for the worsening of an illness or injury (Workers’ Compensation Act, section 19).

6.4

The insurance also covers the sudden soreness of a muscle or tendon (work movement soreness) that was not the result of an accident, but occurred as the person was performing a single strenuous work movement. Compensation is not paid if the soreness is caused by a previous injury or illness or by tissue damage that could only occur as the result of an accident. A maximum of six weeks of compensation is paid for soreness (Workers’ Compensation Act, section 33).

6.5

The insurance also covers occupational diseases, meaning an illness that was likely primarily caused by exposure to a physical, chemical or biological agent at work, in the area where work is carried out or in training (Workers’ Compensation Act, sections 26 to 30).

6.6

The insurance also covers abuse or damage caused deliberately by another person, according to the conditions laid down in legislation (Workers’ Compensation Act, section 34). The insurance also covers mental shock resulting from an accident at the workplace, according to the conditions laid down in legislation (Workers’ Compensation Act, section 35).

6.7

A general requirement for an accident being compensated is a probable medical causal connection between the accident and the injury or illness. In assessing the causal connection, particularly the medical findings and observations, how the accident happened and previous injuries and illnesses are taken into account.

7 Compensation

7.1

Compensation paid under the insurance is determined based on the provisions of the Workers’ Compensation Act.

7.2 Indemnity for medical treatment

Compensation under the insurance is paid for unavoidable expenses resulting from necessary medical treatment (Workers’ Compensation Act, sections 36–37).

Necessary travel expenses arising from hospital treatment are compensated to the nearest place of treatment or to one specified in a commitment to pay. For journeys made in a private vehicle, half of the tax-free rate-per-kilometre compensation confirmed by the Tax Administration shall be reimbursed.

Fennia has the right to direct the injured person to a treatment facility of its choosing using a commitment to pay. If treatment is provided in a treatment facility other than the one indicated in the commitment to pay or if Fennia has not provided a commitment to pay, the injured person shall be reimbursed, at most, the client charge as provided in the Act on Client Charges in Social and Health Care Services.

Compensation for costs such as medical treatment, pharmaceutical, travel and additional home maintenance expenses must be applied for from Fennia within one year of the costs arising.

7.3 Compensation for lost income

The daily allowance is the same amount as sick pay for a maximum of 28 days, not including the day of the accident. Thereafter, the daily allowance is 1/360th of the annual earnings specified in sections 71–74 of the Workers’ Compensation Act.

No other party than the company taking out the insurance is entitled to recover the earnings paid during sick leave or any other benefit from the compensation for lost income paid in accordance with this policy.

8 Termination of the Insurance

8.1

The policyholder may terminate the insurance. The termination must be done in writing. The insurance expires at the earliest when Fennia receives the termination notification.

The insurance is terminated on the last day of the company’s compulsory occupational accident insurance, if the policyholder terminates it in connection with an insurance transfer procedure.

8.2

The insurance is considered to have ended as of the date on which the policyholder has been declared bankrupt or when a bailiff has issued an impediment certificate as referred to in the Enforcement Code, Chapter 3, Section 95, indicating an impediment for lack of means or unknown whereabouts of the policyholder.

8.3

Fennia has the right to terminate the insurance if the policyholder has neglected to pay a due insurance premium, or if the policyholder has deliberately provided wrong or incomplete information required for processing a compensation matter or for determining an insurance premium in order to achieve unauthorised financial gain for him/herself or for someone else.

The insurance ends within 30 days of the written notice of termination being sent. However, the insurance does not end if the policyholder has paid the due premium before the close of the period of notice.

8.4

If it becomes known that the insured has a similar insurance that has commenced previously for the same work with another company, Fennia’s insurance shall be cancelled retroactively from its starting date.

9 Appeals

Decisions issued by Fennia under this insurance policy can be appealed in writing to the Accident Appeal Board, in accordance with the instructions for appeal that are attached to the decision.

10 Applicable Law

This insurance policy is subject to the Finnish Workers’ Compensation Act (459/2015). Upon taking out the insurance the policy is subject to the Insurance Contracts Act (543/1994), section 4 b, paragraph 1; section 5, paragraph 1; section 5 a, and section 7, paragraph 1.

40 426 30