You could be forgiven for thinking that the costs of hospital stays or medical care needed when you have an accident are covered by your compulsory health insurance. But in Switzerland, accidents and illnesses are classified differently for insurance purposes.
Health insurance covers illnesses and injuries which result from illnesses. Injuries which result from extraordinary, external circumstances like a loose tile falling on your head, an insect sting or a fall on the ski slope are classified as accidents. These are covered by accident insurance.
Whether accidents are covered by your health insurance provider or by occupational accident insurance depends on whether or not you are employed.
Two types of accident insurance
In Switzerland, there are two main types of accident insurance – each with its own set of rules and coverages:
1. Employment-based accident insurance
If you are employed by a Swiss employer, your employer is required to take out occupational accident insurance (UVG / LAA), which covers the healthcare costs of accidents that occur in the workplace and occupational health hazards. You employer covers the occupational accident insurance premiums.
If you work for a Swiss employer more than 8 hours per week, you must take out non-occupational accident insurance through your employer. This insurance covers the cost of accidents which occur outside of the workplace. You pay the premiums for non-occupational accident insurance – normally as a direct deduction from your salary – so it is in your best interest to make sure that your employer uses a reasonably-priced accident insurance provider. You can learn more about this here.
If you are unemployed and are receiving unemployment benefits, you are covered by employment-based accident insurance throughout your unemployment benefit entitlement term.
If you are self-employed, you can take out employment-based accident insurance on a voluntary basis if you choose to, but you are not required to do so.
Employment-based accident insurance covers the full cost of claims with no deductible.
Employment-based accident insurance covers:
- Medical expenses. The medical costs of treating injuries – including the cost of treatment and hospital stays, is covered by employment-based accident insurance.
- Loss of income. This insurance pays out a benefit equal to 80% of your insured salary if your injuries prevent you from carrying out your employment duties.
- Disability pension. If an accident results in your becoming disabled, this insurance provides a disability pension which is based on your disability level. The highest pension is reserved for full disability, and is equal to 80% of your insured salary.
- Impairment compensation. If an accident results in your becoming physically, mentally or psychologically impaired, this insurance may pay out a one-time benefit based on your level of impairment.
- Survivors pension. If an accident results in your death, your surviving, dependent children will receive a survivors pension. Your 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. Children with one surviving parent receive a pension equal to 15% of the insured salary, while fully-orphaned children receive a pension equal to 25% of the insured salary. The combined pensions of all your survivors cannot exceed 70% of your insured salary.
2. Health insurance based accident insurance
If you are a child, student, housewife, househusband, self-employed person or unemployed person who is not receiving unemployment benefits, you will not automatically be insurance by employment-based accident insurance.
Instead, you can insure yourself against the costs of accidents by adding an accident insurance rider to your compulsory health insurance policy.
Health insurance based accident insurance covers:
- Medical expenses. The accident insurance rider extends your health insurance policy’s hospital and medical care coverage to include healthcare costs resulting from accidents. The deductible which applies to your health insurance policy is applied to accident insurance claims as well.
Avoid over insurance
When you become employed and begin receiving employment-based accident insurance, you will normally have to inform your health insurance provider so that they can place your accident insurance on hold. This will help you avoid paying premiums for insurance which you do not need.
You can select “With” or “Without” under “Accident coverage” in the health insurance comparison on moneyland.ch to include or exclude accident insurance from health insurance policies and compare premiums for both scenarios.
Other types of accident insurance
In addition to the two basic accident insurance models, a number of insurance providers offer specialized accident insurance policies which provide coverage similar to that provided by employment-based accident insurance. Health insurance providers also offer extended coverage for injuries on some supplementary health insurance policies.
Interim accident insurance
If you prefer to keep the more comprehensive coverage which you receive from employment-based accident insurance after your unemployment benefits entitlement period expires, interim accident insurance is an option.
You can take out this insurance while you are still employed. When you become unemployed, interim accident insurance replaces your employment-based accident insurance for a certain period (up to 180 days). Read the moneyland.ch guide to interim accident insurance for more information.