Bite on a shotgun pellet - a case for accident insurance?

Question:‍

A few weeks ago, I was with friends in a restaurant known for its game specialties. The pleasant evening was abruptly interrupted when I bit into a shotgun pellet in the meat while eating the venison steak. Unfortunately, a considerable part of my upper right incisor broke off. In order to save what could still be saved, I went to the nearest emergency dentist, who subsequently billed me CHF 3,500.00 for the treatment. My accident insurance is now refusing to pay for the damage - is that right?

Answer:

Accident insurance companies are generally only obliged to cover treatment costs if these are the result of an accident. For the assessment of the present case, it is therefore decisive whether the bite on the shotgun pellet is to be qualified as an accident from a legal point of view.

The definition of an accident under insurance law can be found in Art. 4 of the Federal Act on the General Part of Social Insurance Law (ATSG). According to this, an accident is the sudden, unintentional damaging effect of an unusual external factor on the human body that results in impairment of physical, mental or psychological health or death.

The criterion of unusualness is of particular relevance to the present case. According to the case law of the Federal Supreme Court, the decisive factor is that the external factor in the specific area of life must be classified as unusual. In relation to dental damage in the context of food intake, this means that in such cases an accident only exists if the damage was caused by an object that is not usually found in the food in question.

Here are a few examples to illustrate this: The Federal Supreme Court affirmed the unusualness factor in the case of a tooth fracture caused by a bite on a nutshell in a nut loaf (BGE 114 V 169 E. 2) or in the case of a bone splinter in a sausage (BGE 112 V 201 E. 3.b). On the other hand, unusualness was denied in the case of tooth damage following a bite on the figure in a king cake (BGE 112 V 201 E. 3.b).

The Federal Supreme Court has already dealt with a case involving shotgun pellets in game meat. In its ruling U367/04 of October 18, 2005, it came to the conclusion that when eating hunted game in a restaurant, it must be expected that there are remnants of shot or projectiles in the meat. This was not something unusual. The event could therefore not be qualified as an accident, as there was no unusual external factor. Accordingly, the accident insurer's obligation to pay benefits did not apply.

Following this case law, it should be noted in the present case that the accident insurer rightly denied its obligation to pay benefits.

It is therefore advisable to take a particularly close look the next time you eat game specialties to see if there is anything unexpected hidden in the game meat.

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Note: This article by attorney Thomas Räber was published in the Seetaler Bote on May 28, 2025.

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