Accident insurance - application for compensation in the event of an accident

Accident compensation is paid to those who meet the following:

Furthermore, the assumption that health costs will be reimbursed is that they have not already been paid by the health fund, the insurance company or other parties. If the application is made on incorrect grounds, the applicant may be re-claimed for the payments, plus penalty interest.

1. Having had an accident that was unexpected

The applicant must have been involved in an accident which refers to an event which:

• is sudden and unexpected

• causes injuries to the body

• the observer can realise that the event has happened

• occurs without the will of the injured person

• cannot be traced to the underlying disease of the injured person

• is a deviation from the expected scenario

2. Being covered by accident insurance

Employees are covered by accident insurance if they:

• work in Iceland, regardless of age

• work on board ship or aircraft, Icelandic or for the benefit of Icelandic parties, and receive wages in Iceland

Self-employed workers are covered by accident insurance if they:

• are employers in agriculture
  - their spouses and children aged 13-17 are also insured

• independently engaged in non-agricultural activities

• the ship's captains who are themselves crew members

Students are covered by accident insurance if they are in:

• are in certified apprenticeship

• apprenticeship in healthcare subjects or the natural sciences
  - practical training at university

In addition, accident insured persons are:

• Athletes, if an accident in the course of sport qualifies for liability

• Rescue team members, in case of accident during rescue, the conditions for liability are fulfilled

• Those who are injured while working at the home and marked in the appropriate box on the tax return, if an accident while working at the home meets the conditions for liability for benefits

3. That the accident is liable for damages.

Liability related accidents can include work-related accidents, sea accidents, and accidents involving housework, sports, rescue work or industrial training. However, no car accidents which occur in 2014 or later are liable for compensation if they are liable to compensation by the insurance undertaking under the compulsory insurance of civil liability for vehicles or the compulsory accident insurance of the driver and the owner.

Work accidents

Accidents at work are considered liable for compensation if the person concerned was at work when the accident occurred and received wages or reimbursement for work. Such exemption from liability for car accidents applies even if the work involved is in progress. The injured person is considered to be working in:

• workplace during working hours, including meal and coffee.

• same-day missions for the workplace

• same-day journeys between workplace and home

• longer trips, as long as the employee is paid during the trip

Sea accident

Sea accidents are considered liable for compensation if the person concerned received wages due to work or calculated remuneration for work.

Domestic accidents

Accidents while working at home can be liable for compensation if the insurance was checked on an appropriate tax return. The accident insurance is valid from 1 June of the year the tax return is submitted until 31 May of the following year (following the assessment period). It is not possible to request accident insurance after the tax authorities receive a tax return. Housework must have been performed in Iceland at the home of the insured person or the summer home where he/she resides, including garages, storerooms, a secluded garden or driveways. Domestic work that is covered by accident insurance includes:

• traditional household chores, such as cooking and cleaning

• care of the sick, the elderly and children

• maintenance tasks and repairs

• traditional gardening

Excluded accident insurance include:

• accidents in everyday activities that do not involve regular household chores, such as dressing, bathing and eating

• travel accidents, such as camping, caravans and hotels

Accidents in sporting activities

Sports personnel who have suffered an accident are covered by insurance if the injured person is 16 years of age or older, participates in sports and is injured during training, exhibitions or competitions. Sport participation means that the person in question regularly practices at a sports club within the framework of the Icelandic Sports and Olympic Association (ÍSÍ).

Accident while performing rescue work

Accidents in rescue work are covered by accident insurance if the injured person was working to rescue persons from the danger of their lives, or to protect against other imminent major damage.

Accident during an apprenticeship

Accidents occurring during work or work connected with apprenticeship or other studies may be liable for compensation if the presumption of an accident is satisfied.

Occupational diseases

Diseases caused by work or conditions in the work environment are also considered accident-insured, even though the accident is not directly caused. The application is made as if it were an accident at work.

4. That the accident is reported in a timely manner

In general, all accidents should be reported within one year. If there is a problem with getting the employer's signature on a notification, assistance from a legal entity may be sought. If more than a year has elapsed since the day of the accident and the period of notice is shorter than ten years, the notice may be examined for as long as:

• the details of an accident are clear

• the delay does not compromise the collection of data on relevant points

• it is possible to determine the cause and damage to the health of the injured persons