Accident Insurance in Switzerland: It pays to know the rules

A good work-life balance is essential, because it helps reduce stress and prevents burnout. For employers, this could equate to employees performing better, and ultimately, in higher productivity for the company. Switzerland is a very outdoor nation and its often stunning nature offers a vast range of activities, from the relaxing to the adrenalin-soaked amongst its never ending tracks, trails, lakes and mountains.  But participating in dangerous sports, and not having enough experience, or even using the wrong equipment, can have serious ramifications with regards to accident insurance.

Accident insurance is compulsory in Switzerland, and employees participating in leisure and sports activities in their free time, must be correctly insured. If you are an employee, your employer will provide accident insurance for professional coverage – as well as for non-professional coverage, if you work more than 8 hours per week.

In the event of an accident, non-compliance by the insured party, can result in significant reductions in pay-out by the insurance company, so it is worthwhile checking how you are covered particularly at the more extreme end of sport activities.

Rules & Parameters

In Switzerland, it is important to note that accidents and illnesses are classified differently for insurance purposes:

• Health insurance covers illnesses and injuries which result from illnesses.
• If you are employed by a Swiss employer, your employer is required to take out occupational accident insurance (UVG – German or LAA – French).
  • This covers healthcare costs of accidents that occur in the workplace as well as occupational health hazards.
  • By law, these policy payments are paid by the employer
• Additionally, if you work for a Swiss employer for more than 8 hours a week, your employer must also take out a non-occupational insurance policy for you. This covers the cost of accidents that occur outside of the workplace.
• Accident insurance covers medical expenses for both occupational and non-occupational accidents. Accident insurance also covers salary loss from your third day of absenteeism as a result of an accident.
• The employee pays the premiums for non-occupational accident insurance themselves – normally as a direct deduction from the salary.
  • In the above case the employee should also contact their health insurer, to make sure they are not paying twice. However, if you are not an employee then it is important to make sure that you add accident insurance to your health insurance
• Accident insurance covers injuries resulting from extraordinary circumstances, both in occupational and non-occupational scenarios.
  • It is imperative that employers and employees understand the accident insurance cover, as this provides protection against both the health- and financial consequences of occupational and non-occupational accidents.
• Specifically for non-occupational activities, the employee should be aware, of not only the risk-level of the activities, but also in the capability and experience-level of the person engaging in the activity.
• An employee remains insured for 31 days after finishing employment in which case it is recommended to add accident insurance to health insurance in the event of not obtaining a new employed position.
   

Coverage

Accident insurance provides the following benefits:

• Medical costs for the treatment of injuries, including the actual treatment, medicines and hospital stay costs.
• In the case of an accident where the employee cannot work, a payment of 80% of the insured salary is made
• If an accident results in disability, the insurance provider must pay a disability pension.
  • The pension is based on the level of disability suffered. The highest amount paid is for full disability and equal to 80% of the insured salary.
  • If an accident results in either physical, mental or psychological impairment, the insurance provider may pay a one-off benefit based on the level of impairment.
  • If an accident results in death. Surviving, dependent children receive a survivors’ pension, and the surviving spouse may receive a survivors’ pension under certain circumstances – such as when they have dependent children to care for.
  • Widows and widowers receive a pension equal to 40% of the insured salary.

Example scenarios & Recommendations

The “Devil is in the details” as the saying goes, and it pays to check first as to what your insurance policy rules are.

• Given that there are now many more new and dangerous sport arts available, those who participate and take risks can escalate the probability of cash benefits being reduced. So, what is considered as “risk-taking?”
• Sporting activities are divided into three risk levels:
  

  Green No risk	This means no reduction in benefits.
  Orange Relative risk	This could result in cash benefits being reduced by 50% and in particularly severe cases, cash benefits could be refused altogether.
  Red Absolute Risk	Cash benefits reduced to 50% and in particularly severe cases, cash benefits.

• Hiking and Climbing
  • On Safe Routes is considered as being GREEN.
  • On a dangerous route or with little knowledge of climbing, or using poor equipment is classed as a relative risk or ORANGE.
  • Jumping from the summit of a mountain in a wingsuit is classified as RED and a 50% reduction in cash benefits must be expected.

• List of dangerous sports includes (but not limited to):
  • Downhill racing on mountain bikes.
  • Jumps on bikes with acrobatic acts such as somersaults.
  • Quad bike training and racing.
  • Roller board descents.
  • Ski speed record runs.
  • Diving to a depth of more than 40 meters

The basic thing to remember here is that in the case of non-occupational accidents that can be traced back to a risk, the cash benefits can be reduced by half and, in particularly serious cases, refused altogether.

 Swissroll is an advocate of a healthy work/life balance, and our team ethos ensures that we are focused on supporting contractors and employees, with excellent payroll services and more. This equates to having the opportunity to enjoy leisure time when working in Switzerland. Or as we like to say, “Enjoy the lifestyle, rather than form-filling.”

In addition to cultural events and the wonderful nature, there are a myriad of sporting activities to enjoy while in Switzerland. However, it is fundamental to not only have the correct accident insurance cover, but also to abide by the rules and guidelines of the insurance policy.

Our credo is clear:

• When coming to work in Switzerland, be well informed about all the insurances available and required.
  • Especially the non-occupational ones for leisure activity scenarios.
  • This means discussing this with your employer and in the case of contractors, your payroll provider.

• If you plan to participate in any sports, it is also recommended to consult an insurance expert first, to decide on what type of cover is recommended.
  • Even going for a simple hike in the mountains may need to be qualified depending on where you are going and what your experience level is.

• The golden rule with insurance: never assume!

Swissroll GmbH was founded over 20 years ago. During this time our team of experts has worked with hundreds of companies and literally thousands of contractors. Beyond our core function of payroll management, we offer advice to contractors coming to work in Switzerland for the first time. This includes with insurance cover. Contact us now on: enquiries@swissroll.ch   Swissroll: “More than just payroll specialists”