Medical costs

Medical expenses are those expenses that become necessary after an accident so that the injured person recovers or their condition at least does not worsen. This includes doctor’s visits, operations, medications, therapies, hospital stays, rehabilitation measures, and the necessary trips to these treatments.

From a legal perspective, medical expenses are part of the so-called claims for damages. This means that whoever caused the accident must reimburse these costs. The legal basis is § 1325 ABGB. It is important that the costs were actually caused by the accident, that they are medically necessary, and that they are directly related to the injury.

Long-term Cost Consequences for those Affected

Medical expenses are usually the first and, at the same time, the most protracted cost item after a skiing or alpine accident. They begin on the day of the accident but rarely stop after acute care. Many affected individuals are accompanied by this financial pressure for months or even years.

An example illustrates this: After a severe fracture in the ski area, an operation and hospital stay are the first steps. This is followed by crutches, medication, regular physiotherapy, and often a stay in a rehabilitation clinic. Although social insurance covers part of it, much remains. Co-payments, uncovered therapies, and private additional services quickly add up to several thousand euros.

This is where the law of damages comes into play: These costs do not have to remain with the victim but can be claimed from the opposing party or their insurance company.

Typical Costs in Practice

Medical expenses include a wide range of expenses. These include, for example, medical treatments and operations, medication and bandages, physiotherapy and rehabilitation, therapeutic devices such as splints or wheelchairs, psychological care, stays in rehabilitation centers, and trips to doctors or clinics.

Particularly important: Even costs that are only intended to prevent the health condition from deteriorating count as medical expenses. A classic example is regular therapies that prevent movement restrictions.

Bearing the Costs

In principle, the opposing party in the accident reimburses the medical expenses. In practice, this is often covered by their liability insurance. Social insurance only covers a basic part. Own additional insurance policies can help, but many affected individuals must first pay the bills themselves and then claim them.

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Important Documents for Enforcing Claims

Insurance companies examine medical expenses particularly strictly. Therefore, clean documentation is crucial. This includes invoices from doctors and hospitals, medical findings and therapy reports, prescriptions for medication and aids, proof of rehabilitation stays, and receipts for travel expenses.

It is best for those affected to file all documents in a separate folder immediately after the accident. Even better is to additionally scan or photograph the documents and save them digitally. This way, nothing is lost, and the enforcement of the claim is much easier later.

Enforcement of Claims

As a rule, the enforcement of medical expenses begins with an extrajudicial letter of demand. In it, we describe the course of the accident, list the costs incurred, legally justify the claim, and set the other party a clear deadline for payment. The goal is to achieve a quick settlement without court proceedings.

Often, at this stage, the opposing party demands a medical expert opinion to verify the necessity and appropriateness of the treatments claimed. Even if this seems burdensome for those affected, such an opinion can strengthen the position, as it creates a professional basis on which the proceedings can be based.

If no agreement is reached despite the request and expert opinion, judicial enforcement remains. In this case, we claim the medical expenses by filing a lawsuit at your request. The court examines all documents, considers expert opinions, and hears witnesses if necessary. In the end, it decides on the obligation to pay compensation, often in the form of a judgment or a settlement.

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Requirements for Reimbursement

For medical expenses to be reimbursed, they must be caused by the accident and appear medically necessary. Luxury or cosmetic treatments without medical indication are not included. The opposing party must also be responsible for the incident. In the case of cable car accidents, a special strict liability applies under the EKHG, which makes it easier to enforce claims.

The behavior of the injured person also plays a role: Anyone who grossly violates safety rules, such as riding without a helmet or entering restricted areas, risks a reduction by the insurance company.

Your Benefits with Legal Assistance

We make your medical expenses our task:

• We structure the collection of evidence, tell you exactly which documents are important, and actively support you in the preparation.
• We take over the communication with your legal expenses insurance so that coverage is secured.
• We create a comprehensive letter of demand that clearly presents your claims.
• We represent you in court if the opposing party does not give in.
• We are also at your side in criminal proceedings. After skiing accidents, investigations are regularly carried out for negligent bodily harm. As long as the question of guilt is open, both parties involved in the accident are usually treated as suspects. We ensure that your rights are protected in these proceedings as well.

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Frequently Asked Questions – FAQ

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