A unique type of insurance
There is a unique type of insurance available in Sweden for those suffering from adverse effects of pharmaceutical treatment. The Pharmaceutical Insurance covers everyone who has been treated with prescribed pharmaceutical products or pharmaceuticals purchased from a legitimate dealer in Sweden. It also extends to include patients who received their pharmaceuticals at a hospital or who are suffering adverse reactions or effects owing to participation in clinical trials covered by the insurance.
Presenting your case to the Pharmaceutical Insurer is the quickest and simplest way to receive compensation in the event of drug-related injury. There is also the option to take your case to court, but the burden of proof may be greater.
Information for patients
When you have submitted your claim, it is processed by a claims adjuster. You will receive confirmation from the insurance company that your claim is being processed. Often, the claims adjuster will need to request medical records, invalidity certificates and statements from specialists. The assessment and evaluation process is conducted in consultation with experts in medical science.
When the evaluation has been completed, you will be notified of whether or not you are entitled to compensation. Following this decision, an assessment of the extent of the compensation is made. This is made in accordance with the general principles governing the Tort Liability Act. The intention is that you should be in the same financial situation as you would otherwise be if the injury had not occurred.
On average the process takes about four months from the date on which you submitted your claim to the date on which you receive the decision regarding your entitlement to compensation. Cases can vary depending on the degree of complexity.
The time required to assess the extent of the compensation may vary depending on whether or not the injury can be regulated directly or if a decision must be delayed until such matters as possible invalidity settlement or sickness benefits are addressed.
If you are not satisfied and would like to dispute the decision made by the Pharmaceutical Insurer, you may appeal to the Pharmaceutical Injury Panel, which is an independent panel comprised of experts in medical science, laymen and representatives of the legal profession, appointed by the government. The opinion of the panel is advisory, but the Pharmaceutical Insurer usually follows their recommendation.
If you are dissatisfied with the insurers final decision following the Pharmaceutical Injury Panel, you may institute general proceedings at a general court against the insurer and in that way appeal against the decision. For claims notified before January 1, 2007 any dispute will be settled by arbitration.
The Pharmaceutical Insurance, the Patient Insurance and the Road Traffic Insurance are three insurances that go hand in hand. They provide compensation not normally covered by ordinary healthcare insurances. When the decision to pay compensation has been made, the amount is determined in accordance with the norms established in Tort Liability Act – the tables are adjusted on an annual basis.
Should your injury require medical attention or hospitalisation, this is covered by your normal health insurance. However, you may be entitled to compensation for pain and suffering from your Pharmaceutical Insurer.
You may also be entitled to receive compensation for additional expenses incurred as a consequence of the injury. Receipts must be presented.
The insurance may also compensate for loss of income during the period of illness. Should you have permanent injury, you may be entitled to compensation for bodily defect or permanent harm. The degree of invalidity is evaluated based on special norms.
Should your injury result in permanent additional expenses or inconvenience, you may be entitled to compensation for these. You may also be entitled to receive compensation for loss of income over an extended period of time. This may be in the form of an amount to cover loss of income or an annuity. Sometimes it is uncertain whether an individual will be able to resume work or not, and in such a case the insurance company will monitor the individual’s state of health until this has been determined.
If you have received a personal injury that with preponderant probability has been caused by a pharmaceutical and which could not reasonably have been predicted by the doctor, then indemnity will be disbursed. Personal injury covers both physical injury and mental illness, but psychological complaint must have a medically demonstrable effect in order to be considered to be a personal injury. The injury must be more severe than the primary complaint from which you are suffering.
The insurance does not cover injury caused by naturopathic products or homeopathic remedies. If you are uncertain as to whether the insurance applies to your injury, you may always submit a claim report to have your case tried.
A claim should be submitted within three years from when the patient became aware of the injury. The absolute limit for submission is 15 years after the patient stopped taking the pharmaceutical.
Information for companies
LFF Service AB is created for companies and organisations that work with pharmaceuticals in Sweden. Owning a share in the company ensures patients using any shareholder’s pharmaceutical product the right to get his/hers injury investigated by the Pharmaceutical Insurance and if relevant get imbursed by the insurance.
98 percent of the companies manufacturing and marketing pharmaceutical products in Sweden are shareholders. However, LFF shareholders also include universities that engage in research into medical drugs, biotechnology companies, companies involved in clinical trials, and distributors of medicines.