Compulsory accident insurance in seven steps

Sep 7, 2020.

Totalling exactly 120 legal articles, strictly structured under eleven titles with 23 chapters, the Swiss Federal Act on Accident Insurance (UVG) is definitely not an easy read. What obligations apply to companies and employees? And what coverage gaps are you best advised to close? Protect yourself and your team from financial loss and create a clear strategy. Our seven steps guide you through the maze of regulations.

1. Find out and clarify: Which employees have compulsory accident insurance? 

Every employee in Switzerland who is gainfully employed under the provisions of old age and survivors’ insurance (AHV) is subject to compulsory accident insurance. In principle, any activity that is carried out by a person in an employment relationship in return for a salary is considered to be non-self-employed.

The Federal Compensation Office specifies: “Under social insurance law, a person is considered to be gainfully employed if he/she performs work in a subordinate position ( … ) without bearing any economic risk.”
 

The following groups of people are also covered by compulsory accident insurance:

  • Teleworkers
  • Apprentices (including trial apprentices)
  • Trainees
  • Volunteers
  • Employees in trainee and disability workshops
  • Anyone who is entitled to unemployment benefits


Compulsory accident insurance is also stipulated for all employees with collective employment contracts, such as the collective employment contracts common in the hospitality and construction industries.

 

Insurance coverage always begins on the first working day and includes occupational illnesses as well as accidents.
 

Generali tip: an AHV personal insurance number is a clear indication of the employer’s obligation to insure employees against accidents at work.

 

 

2. View contracts: what role do working hours play with respect to compulsory accident insurance?

Regardless of how long the working day is, in the event of an accident at their place of work or on their way there, all employees have compulsory insurance coverage. The employer pays the premiums.

Additionally, non-occupational accident insurance is compulsory for anybody working eight hours or more per week. This means that insured persons are also legally protected against accidents that occur at home and during sport and leisure activities. However, employees generally bear the insurance costs for this themselves.

Generali tip: employers who also pay premiums for non-occupational accident insurance promote employee motivation and retain valuable employees in their company.

 

 

3. Recognise Exceptions: what about family members, service providers and board members?

Not everyone who performs work for pay is covered by compulsory accident insurance in every case. These are the main exceptions:

  • Self-employed individuals (such as entrepreneurs or freelancers who provide services for the company for a fee)
  • Family members of employees who do not receive cash wages and are therefore not registered with the AHV (also direct relatives of the manager of a farm and sons- or daughters-in-law who plan to take over the farm)
  • Federal officials covered by military insurance
  • Board members who are not employed in the company themselves
  • Part-time firefighters
  • Persons acting in the public interest without a special service contract
  • Members of parliaments, authorities or committees

 

These exceptions are not specific to an individual. It depends on the activity in each particular case. That means a firefighter, a member of the National Council or even a farmer’s son-in-law may be covered by compulsory accident insurance if they carry out another activity that is definitely subject to the Accident Insurance Act (UVG).

 

 

4. Note the differences: Sole proprietorship, limited liability company (GmbH) or stock corporation (AG)  how does the type of company impact compulsory accident insurance?

In accordance with the UVG, managing directors of limited liability companies and board members of stock corporations or other general partnerships are treated in the same way as their employees. Thus, they are always covered by compulsory accident insurance, just like every other employee.

 

The situation is different for owners of sole proprietorships and their family members. They can take out voluntary insurance at any time, however.

 

Companies of all types and people in all functions are free to choose supplementary accident insurance.

 

Overview:

Compulsory insurance for owners No, can be insured voluntarily Yes, the same as employees
Mitarbeitende Familienmitglieder No, can be insured voluntarily Yes, the same as employees
Co-working family members Covered by compulsory insurance Covered by compulsory insurance
Supplementary accident insurance possible Yes Yes

5. Classify the business correctly: where do I have to take out compulsory accident insurance for my employees?

Certain companies insure their employees through Suva, the Swiss National Accident Insurance Fund. This holds true for the following industries:

  • Civil engineering
  • Mechanical engineering
  • Chemical companies
  • Transportation of goods and people
  • Carpentry, locksmithery businesses
  • Food manufacturing
  • Electricity, gas and water utilities
  • Temporary staffing
  • Architecture firms
  • Engineering companies

 

A detailed list of the sectors that are subject to Suva can be found in Article 66 of the Accident Insurance Act (UVG).

If you are not sure whether your company is subject to Suva, you can ask one of the local Suva agencies.

If your company is not subject to Suva, you can apply for compulsory accident insurance with private insurance companies, such as Generali. There you will find a competent team of experts available who will be happy to assist you at any time with any questions you have relating to compulsory accident insurance.

6. note the Legal situation: what benefits does compulsory accident insurance cover?

The Accident Insurance Act provides for the following benefits depending on the claim:

  • Medical treatment at home and abroad
  • Travel, transportation and rescue costs
  • Daily allowance
  • Home care
  • Medical aids
  • Property damage
  • Disability pension
  • Impairment compensation
  • Helplessness benefits
  • Funeral costs
  • Survivor’s pension

 

Since each individual case requires careful examination and medical assessment, it is important to report accidents and work-related illnesses to the insurance provider as soon as possible and to present a corresponding medical certificate.

 

The duration and amount of the benefits can vary depending on the claim.
 

 

7. Check benefits: what coverage gaps can arise despite the UVG obligation?

In many cases, the statutory benefits from compulsory accident insurance do not cover all actual costs. Appropriate supplementary insurance closes these gaps (see table).

 

The following options may be useful. Here is a selection:

  • The UVG pays for treatment costs in Switzerland and abroad – but not for a free choice of doctors and hospitals. If your employees prefer to receive optimum medical treatment (by the chief doctor, for example) and be cared for in a private room, supplementary insurance (UVG-Z) can be taken out to cover this
  • The daily accident benefit usually paid out from the third day after the start of the incapacity to work amounts to a maximum of 80% of the employee’s salary. (See AHV/IV). Optimum coverage of the actual loss of earnings can be achieved through supplementary accident insurance. A daily hospital allowance can also be arranged.
  • Compulsory accident insurance takes effect on the employee’s first working day and usually ends on the 31st day following termination of the employment relationship. (See Admin media release). You can extend this period to a maximum of 180 days after leaving the company by way of an individual agreement. During this time, non-occupational accidents are covered by private supplementary insurance.
  • In accordance with the law, the maximum insurable annual salary is CHF 148,200. Additional insurance covers the difference from an actual salary of up to CHF 300,000. This helps prevent any significant losses in the event of inability to work in individual cases.
  • If serious consequences to the employee’s health result in disability, the employee receives a statutory pension depending on the degree of his/her incapacity to work. With supplementary insurance, this can be increased individually or alternatively converted into a lump-sum disability benefit. Optionally, a lump-sum solution can also be chosen for survivors’ pensions.
  • Finally, private insurance companies, like Generali, also offer protection in case the statutory benefits from compulsory accident insurance are reduced or even refused. For example, in the event of a grossly negligent accident or a particularly hazardous activity. The resulting differences are also covered by supplementary insurance.

 

 

Overview of accident insurance – continued salary payments in the event of an accident

 

 

Unlike in many other countries, accident insurance in Switzerland is an independent part of the social insurance system. The legal basis for this is the Swiss Federal Act on Accident Insurance (UVG) of 20 March 1981, which was partially revised in 2017. The act is supplemented by the Ordinance on the Prevention of Prevention of Accidents and Occupational Diseases (VUV).

 

Because of the statutory insurance obligation, many people talk about compulsory accident insurance. The comprehensive legislative package governs the insurance coverage of employees in detail in the event of an occupational accident (OA), non-occupational accident (NOA) or an occupational illness.

 

The most important difference between this and the benefits provided by health insurance companies is that, in accordance with the provisions of the UVG, accident insurance covers not only the cost of treatment but also pension claims – for example due to an incapacity to work or disability.

 

Anyone who violates the information and reporting obligations associated with compulsory accident insurance must expect to face liability claims, fines or – in extreme cases – even a prison sentence. Compliance with the regulations is monitored by the cantonal compensation offices (e.g. AK Zug).

 

 

“Employees’ sense of appreciation and social security is a powerful driver of motivation and loyalty. Employers who score points with compulsory accident insurance and a choice of suitable supplementary benefits make a key contribution towards cultivating a top-quality corporate culture while simultaneously improving their employer branding. A thorough analysis of suitable insurance solutions is a first step in that direction.”

Andrea Juric, Head of Underwriting Health, Generali Switzerland

The expert

Andrea Juric is the Team Leader of Underwriting at Generali Switzerland. Thanks to her many years of experience, she makes a major contribution to the success of tailored insurance strategies for companies of all sizes and in all industries. Our agents and our brokers alike trust Andrea Juric’s expertise when it comes to finding the best business solutions in the insurance segment. Based on that expertise, they are able to give our business customers the best possible advice.

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