Accident claims: the documents, and which cover pays

Two layers, and which one you are in

A claim after a work accident can touch two different covers. Knowing which is which decides who you file with and what the amount is based on.

Where the cover comes from. Accident and liability insurance on this service are package features: accident cover is included in the Smart and Responsible packages, liability cover in Responsible only, and Basic has neither. Lump-sum compensation for permanent injury is typically paid from the accident cover, so which package you invoice on decides whether there is a policy to claim against at all.

YEL is a different question. A self-employed person invoicing under their own Business ID is in another position again, and there the statutory pension side runs through YEL, which no package here includes.

The live version of this page sourced accident cover to YEL for everybody. That is not where it comes from for someone paid through an invoicing service, and the distinction changes which figure a claim is calculated on. The insurance terms are what govern it: this page describes the process, the terms decide the entitlement.

If you are unsure which applies to you, ask before you need to know.

Permanent injury (pysyvä haitta)

“Permanent handicap” in Finland is a medical classification, not a statement about whether you can work. It means the body is permanently impaired, and it is assessed against the Ministry of Social Affairs and Health’s classification.

The E statement (E-lausunto)

What it is. The medical form used for accident and traffic injuries, recording the first examination, the diagnosis and the immediate cause.

When. At the first doctor’s visit. Ask for it then. It is the foundation of everything that follows, and reconstructing it later is difficult.

The B statement (B-lausunto)

What it is. A fuller statement in which the doctor assesses your functional capacity (toimintakyky), whether the impairment is permanent, and what rehabilitation is needed.

Why it decides the money. The insurer sets the degree of handicap (haittaluokka, 1 to 20) from it, and the class determines the compensation.

This is the document worth taking seriously. If the assessment does not describe your actual limitations, say so at the appointment rather than after the decision.

Notification of injury

Filed with us or with the insurance partner. It must state:

• Time and place: during work, or on the journey to or from it. This distinction matters.
• Circumstances, specifically. “I slipped on ice walking to a client meeting” rather than “I hurt my back.”

File it promptly. A gap between the accident and the notification is the thing that turns a straightforward claim into a contested one.

Lump sum or pension. They answer different questions

A lump sum compensates the permanent injury itself, on the haittaluokka. It does not depend on what you earn, and it does not repeat.

A disability pension replaces lost earning capacity over time. It depends on a confirmed income figure, and this is where the two routes diverge: for a self-employed person the statutory disability pension is calculated from confirmed YEL work income (työtulo), not from what you actually invoiced.

That is the practical argument for setting the YEL figure honestly, and it is the same argument as the one about sickness and parental allowance, YEL and an entrepreneur’s social security.

A claim can involve both: the lump sum for the injury, the pension for the lost capacity.

Loss of income

Payslips alone are generally not enough. You will be asked for the documents that establish the income the benefit is calculated from: for a statutory disability pension, your latest decisions from your pension provider showing the confirmed YEL work income.

Gather these when the claim opens, not when it is queried.

Accidental death

Strictly regulated, and the documents are not negotiable for the beneficiaries.

Police investigation report. Every accidental death in Finland is investigated by the police, to rule out crime and establish the cause. Insurers generally require the report before paying accidental death compensation.

Death certificate, issued by the treating doctor or a forensic pathologist. The cause-of-death section is what establishes an external cause rather than a sudden illness: accident insurance does not cover illness, and that line is where many claims are decided.

Estate inventory deed (perukirja), or an extract from the population information system (virkatodistus). This establishes who the heirs and beneficiaries are, so the insurer knows whom to pay.

What to do at the time

1. Get treatment and ask for the E statement at the first visit.
2. Write down what happened while it is fresh: time, place, what you were doing.
3. Notify us or the insurer promptly.
4. Keep every document you are given, including the ones that seem routine.
5. Read the terms for what is covered and excluded: insurance terms.

If something is unclear, ask. This is the part of the service where getting the sequence right early is worth more than anything we can do later.