Accident insurance (Switzerland)

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In Switzerland , accident insurance is a branch of social insurance. The legal basis for this is the Federal Act of March 20, 1981 on Accident Insurance (SR 832.20).

Insured risks

  • An accident is the sudden, unintended damaging effect of an unusual external factor on the human body, which results in impairment of physical, mental or psychological health or in death.
  • An occupational disease is an illness that has been proven to have been caused exclusively or predominantly by occupational activity.

Health impairments that are not the result of accidents are considered illnesses; the treatment costs for illnesses are covered by the health insurance companies. However, since the accident insurance benefits are better for the insured person - the health insurances do not pay out pensions - the insured persons have a great interest in being able to prove the existence of an accident.

Insured persons

All gainfully employed people in Switzerland are insured against the consequences of occupational accidents and diseases. The employer bears the premiums for the occupational accident insurance.

Employees who work at least eight hours a week for the same employer are also insured against the consequences of non-occupational accidents (NBU) through this employer. The premiums for non-occupational accident insurance are generally borne by the employee, but they are partially paid by employers.

Insurance cover lasts for a full month (maximum 31 days) beyond the end of the employment relationship. The employee can extend this additional coverage period to 6 months by means of a so-called "agreement insurance".

For people who are not insured against the consequences of accidents through accident insurance, the health insurance company bears the costs of treatment after accidents. Such persons have to pay a premium surcharge for their health insurance.

insurer

Employees in some sectors are insured with SUVA (cf. Art. 66 UVG). In all other sectors, the employer chooses an approved private insurer.

Services

A prerequisite for entitlement to benefits is that the damage to health is adequately causally caused by the accident. The more time that has passed since the accident, the more likely it is that a dispute can arise as to whether damage to health is actually still to be regarded as caused by the accident.

Before the "case closure"

As long as a substantial improvement in the health of the insured person can be expected from the medical treatment, the accident insurance will cover the costs of the medical treatment. If there is also an incapacity for work , a daily accident allowance is paid. As soon as no further significant improvement in the state of health can be expected, a so-called "case closure" takes place; the benefits for daily allowance and treatment are "discontinued".

After the "case closure"

Also exists after the fall conclude with a disability of min. 10%, one is disability pension aligned. If the insured person suffers permanent and substantial damage to their physical, mental or psychological integrity as a result of the accident, a one-off " integrity compensation " will also be paid. "Helpless" people may be entitled to helplessness allowance.

In death

If the insured person dies as a result of the accident, the accident insurance covers part of the costs for the transport of the corpse and the funeral. Some of the survivors' pensions are also paid out.

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