Finger amputation following a minor injury: insurance aspects in Germany and practical approaches

Abstract

Expert medical assessments are an integral part of a physician's sphere of activity today. Since subspecialisation is constantly advancing, there is often a limited pool of medical experts available for specific assessment matters. Medical experts have to assess the full proof of facts and the probability of correlations. As regards assessments issued to the statutory accident insurance, the issue of possible pre-existing conditions/damage plays an important role in the discussion surrounding the grounds for liability. Occasional causes or minor injuries are relevant for insurance claims and must be recognised.An insured person with an acral, non-arteriosclerotic circulatory disorder (thrombangiitis obliterans) was involved in an accident at work that resulted in a soft tissue skin defect and the need to amputate the finger. A vascular medical examination found that there was no occasional cause. A hand surgery expert proposed a 25 percent reduction in earning capacity. The accident insurance company followed the decision of the medical experts.