Claims handling

The claims handling process is made up of the following steps:

Recording of notice of injury

When a new notice of injury arrives at the Finnish Mutual Insurance Company For Pharmaceutical Injury Indemnities, the case is recorded and given a handling code.

Required documentation

Once the injury notice is recorded, the Finnish Mutual Insurance Company For Pharmaceutical Injury Indemnities acquires documentation extensive and thorough enough for handling the claim, on the basis of information recorded on the notice of injury.  The Finnish Mutual Insurance Company For Pharmaceutical Injury Indemnities asks the treating institution direct for the required documents even if the notice of injury were accompanied by patient records.  Enclosed in the company’s request is a copy of the notice of injury, sent for information to the treating institution.  Although the process is time-consuming, it is worth while to get as extensive a set of documents as possible for use as the basis of claims handling.

Statement from medical adviser

Once the required patient documentation is obtained, the case is assessed from the medical perspective.  This usually translates into a specialist opinion from a medical adviser.

Decision

On receipt of the information and specialist opinions required for deciding on the case, the Finnish Mutual Insurance Company For Pharmaceutical Injury Indemnities issues a written decision on the case.  In its decision the Finnish Mutual Insurance Company For Pharmaceutical Injury Indemnities takes a stand on whether the reported injury is compensable under the terms and conditions governing pharmaceutical injuries insurance.  The ensuing acceptance or denial is sent to the claimant.  The decision is accompanied by appeal instructions.

Payment of compensation

In its acceptance, the Finnish Mutual Insurance Company For Pharmaceutical Injury Indemnities informs the claimant as to what kind of compensation is paid and attaches a claim form to this acceptance. The claimant is also given further details of next steps to be taken in the matter.  Compensation for pain and suffering is paid at the time the notice of injury is accepted if only possible on the basis of the information available.