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Accidental Toilet Falls in a Clinic Can Be Insured under Certain Circumstances

Hospital patient sustains injury from a fall in the restroom. Is her accident coverage valid?

Hospital patient sustains injuries from a fall in the restroom. Is insurance coverage active?
Hospital patient sustains injuries from a fall in the restroom. Is insurance coverage active?

Accidental Toilet Falls in a Clinic Can Be Insured under Certain Circumstances

In a hospital's stroke ward, accident insurance might cover a patient who takes a tumble from the toilet, as per a ruling by the Federal Social Court (BSG) in Kassel. It all went down when a woman from Berlin took a beating in 2019, treated in a hospital for a brain hemorrhage, speech disorders, and hemiparesis. The unfortunate event happened while she was havin' a sit on the porcelain throne. A nurse escorted her but left the room, only to find her hittin' the floor a moment later, hurtin' her right arm.

The Employers' Liability Insurance Association didn't want to acknowledge it as a work accident. The woman tried her luck at the Berlin Social Court, but struck out. The Berlin-Brandenburg Higher Social Court (LSG) followed suit, deeming the bathroom business to be in the private realm, and not a medically ordered mobility exercise. No special threats due to the situation in the room were found either.

BSG has since sent the case back to the LSG. While a toilet visit is typically private, insurance could cover an accident if it's because of unique hospital hazards or lack of safety measures. The BSG thinks it's essential to consider whether the hospital room's bathroom facilities were designed in a way that enables patients to use 'em without risk. This could mean equipping 'em with a stool or grab bars.

The LSG will now investigate if the necessary structural and spatial precautions were in place on the ward. Hospitals and healthcare facilities generally have a duty of care to guarantee patient safety, includin' measures like preventin' falls, providin' assistance, and designin' accommodations for patients with mobility issues.

However, the court's specific expectations for hospital bathroom safety in relation to stroke ward patients as laid out by the Federal Social Court in Kassel weren't found in any of the available court decisions or legal documents. It might be a good idea to consult the court's own rulings on healthcare facility safety standards for a better understanding of the subject.

  1. The Federal Social Court (BSG) in Kassel has suggested that in light of specific safety concerns associated with hospital environments and medical-conditions like stroke, health-and-wellness insurance could potentially cover accidents occurring in the bathroom, especially if the facilities lack essential safety measures such as stools or grab bars.
  2. In the ongoing case of a stroke patient who fell from the toilet in a hospital's stroke ward, there is a question regarding the exact safety standards for hospital bathrooms, as outlined by the Federal Social Court in Kassel, and it may be beneficial to refer to the court's own rulings for a clearer understanding of these standards.

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