Accident insurance

Who is insured?

  • Any employee working in Iceland if salary is paid in Iceland. Work aboard an Icelandic vessel or aircraft or vessel or aircraft owned or operated by an Icelandic party is equivalent to work in Iceland if salary is paid in Iceland.
  • Farmers injured while performing farm related duties. This includes spouses and children aged 13-17.
  • Self-employed individuals, other than farmers.
  • Members of rescue squads, injured in the process of rescuing lives or setting up preventions against major property damage.
  • Trade students in accredited trade studies as well as university students and students studying health care or science while completing on the job training.
  • Athletes, 16 years and older, while participating in training, shows or competition. The athlete must be training regularly under the guidance of a coach within a sports club that is part of The National Olympic and Sports Association of Iceland.
  • Those performing domestic duties and have voluntarily ensured their entitlement to occupational injury benefits by making a request for such insurance on their tax return at the beginning of each year.
  • Patients who have been treated in government funded health care facilities before the year 2001 and the treatment results in disability or other health issues. Since 2001, these cases fall under Patient insurance (Sjúklingatrygging).

What types of Accidents are covered?

  • Work related accidents, including travel to and from work. However, vehicle related accidents occurring while traveling to and from work on or after 01.01.2014 are not covered as they are covered by the vehicle´s liability insurance.
  • Accidents occurring while working under apprenticeship.
  • Rescue related accidents.
  • Sports related accidents while training, competing or during exhibitions with a recognized athletic club.
  • Accidents in the home while performing domestic duties
  • Health issues or disability related to surgeries or mistakes during treatment by health care professionals (incidents before 2001).

To be covered the accident must be caused by a sudden extraneous, external event. 

Application for benefits

In the occurrence of an accident which is considered to make the insured eligible for benefits under the occupational injury insurance, the employer, or in the absence of an employer, the insured person, should immediately report the incident to the Icelandic Health Insurance on the form Notification of accident. The application should be turned in with an injury certificate from the first doctor/health care facility visited due to the accident.

If outside the capital area, the application, together with all necessary information, may be turned in at the office of Sýslumaðurinn. All documents may also be scanned and uploaded in Réttindagátt – mínar síður, which is a gateway accessible on www.sjukra.is for individuals to access personal information and turn in documentation electronically. Electronic ID or Ice key (Íslykill) is needed.

Benefits

Benefits must be claimed within one year from the accident. However, benefits may be paid even when more than one year has elapsed if circumstances are so clear that the delay does not obstruct the collection of evidence relevant to the case.

The insurance comprises refund of expenses due to medical assistance, per diem cash benefits, disability benefits and death grants.

Medical expenses

The cost of necessary treatment related to the accident is reimbursed in accordance with the Icelandic Health Insurance´s fee schedule. Refund is to be requested on the form Refunds of medical expenses due to accident insurance and submitted with original receipts.

Medical expenses related to accidents occurring on or after 01.01.2014 are reimbursed for up to 5 years from the date of the accident.   

Per diem cash benefits

Per diem cash benefits (slysadagpeningar) are payable from and including the 8th day the injured person has been unable to work due to the accident. The injured must be unable to work for at least 10 days to be entitled to per diem benefits.

The per diem benefits are paid until the injured person is either able to work, is adjudged to be permanently disabled or until death, but in no case for more than 52 weeks. The cash benefits are flat-rate benefits, but payments must never exceed ¾ of the remuneration received for the employment at the time of the accident.

An additional cash benefit is paid for each child the injured party is supporting financially.

Cash benefits from Icelandic Health Insurance are not granted to the injured party until wages have ceased. Employees may be entitled to continued payment of wages and salaries for a certain period in case of accident at work in accordance with collective agreements. During this time frame, the cash benefits are paid to the employer.

Cash benefit payments to those receiving pension payments from the Social Insurance Administration (Tryggingastofnun) may affect related, additional benefits. Please see further details on their website www.tr.is

Invalidity benefits

If an injury results in permanent disability, 75% or more, the injured party is entitled to a full invalidity pension. Payments for permanent invalidity below 75% are paid in proportion to the percentage of invalidity. If the loss of capacity is less than 50%, Icelandic Health Insurance may pay a lump sum equivalent to a pension for the individual concerned for a given number of years. No benefits are paid for loss of capacity that is 9% or less.

Death grants

If an injury results in death within two years from its occurrence, death grants are paid according to specific provisions.

A widow/widower receives a monthly grant for eight years. A pension is paid for each child under the age of 18. Benefits are also paid for disabled children 16 and older who were dependent on the deceased when the injury occurred, depending on the extent to which the child was supported by the deceased.

Forms

Back

 


Language:

This website is built with Eplica CMS