What injuries are covered

Pharmaceutical injury refers to any bodily illness or injury or a psychic disease likely to result from a pharmaceutical taken by the injured party.

Pharmaceutical injury is always an injury to person.

How causal connection is established Before any compensation can be paid, there must be a likely causal connection between the use of the pharmaceutical and the adverse effect. Use of pharmaceutical must turn out to be the most likely cause of the injury when all the causes are considered as a whole. If this causal connection is considered to be merely possible in a situation where there are many other possible causes to the injury and use of pharmaceutical is not any more likely than the other causes, the injury is not covered.

This causal connection is established with the help of information contained in adverse effects registers and compiled works published thereon as well as in medical journals. Other factors considered for this purpose include the person's overall health and diseases, treatment received, and any other medication taken.

Compensable pharmaceutical injury
To qualify for compensation under pharmaceutical injuries insurance, use of pharmaceutical must result in a loss of functional ability lasting at least 14 days without interruption or in a permanent physical injury or illness or death. If the injury is not severe enough to meet any of these descriptions, the injured is only paid compensation for the expenses incurred and loss of income suffered, if these together amount to more than €85 after deduction of any amounts that may be due out of public or statutory compensation schemes.

Compensable pharmaceutical injuries and policy exclusions are defined in more detail in the terms and conditions governing pharmaceutical injuries insurance.

Exclusions
Use of pharmaceuticals often involves the possibility of adverse effects. An injury is not covered if it results from medically necessary risk taking in the treatment of a disease or injury which, if left untreated, is life-threatening or may lead to severe physical injuries.

Neither is an injury covered if the adverse effect of the pharmaceutical is reasonably tolerable in view of not only the nature of the disease or injury that is being treated, the health of the injured and the extent of the injury but also specialists' possibilities and opportunity to foresee the effects of the pharmaceutical as well as other similar circumstances.

Insignificant injuries are not covered
Pharmaceutical injuries insurance does not cover failure of the drug to have the intended effect, ie failure to cure the disease or injury that was being treated.

Pharmaceutical injuries insurance only covers adverse effects caused by due medication. If a pharmaceutical has been incorrectly prescribed or administered, judging by the standard of experienced professionals, or if the injury results from a prescription drug delivered from the chemist's contrary to the prescription or applicable regulations, the injury may be compensable under the Patient Injuries Act. Compensation for such injury can be claimed from the Finnish Patient Insurance Centre using the relevant form.

The policy conditions also exclude injuries resulting from use of pharmaceuticals acquired illegally or from misuse of pharmaceuticals.

 

Compensations
Exclusions
When do exclusions apply
How the claims process advances

24.03.2015