Full cost responsibility (TÄKY)
When occupational accidents and diseases are treated by a public health care provider, insurance companies pay for the full cost of medical care itemised in the municipal invoice to the municipality or joint municipal authority responsible for providing the medical care service (the TÄKY fee). The injured person is compensated for the client fee he or she has been charged.
The TÄKY fee is payable if the claim event and medical care given are compensable under the Workers’ Compensation Act. To enable the insurance company to make the decisions on the compensability of the claim event and medical care, the care provider must provide the insurance company with the treatment record and employer details without delay. Without this information, the insurance company cannot make a decision about the compensability or pay the TÄKY fee.
If a treatment plan is made for the medical intervention, the TÄKY fee cannot be paid unless the treatment plan is sent to the insurer within four (4) days from the date when the entries concerning the plan must be made in the patient documents. Under section 18(1) of the Decree of the Ministry of Social Affairs and Health on patient documents (298/2009), the patient document entries must be made within five (5) days from the date when the patient leaves the clinic or the service event is otherwise closed. In the case of such further treatment, the insurance company may issue a payment commitment for a care provider of its own choosing.
The insurance company has the right to receive the patient document entries and notifications related to the TÄKY fee free of charge.
The TÄKY system will not be applied in the following cases:
- occupational accident occurred before 1 January 2005;
- occupational disease manifested before 1 January 2005; or
- medical care is given in a claim event compensable by the voluntary leisure-time insurances referred to in the Workers’ Compensation Act.
Letter regarding the invoices for TÄKY fees | 3 March 2014 (in Finnish)
Insurance company contact persons for investigating TÄKY matters | updated on 6 August 2016