Accident in Switzerland

Frequently asked questions relating to accidents

  1. Is a tick bite or wasp sting considered an accident?
  2. Do I have to bear my share of the costs myself if I have suffered an accident?
  3. When can I exclude accident cover if I'm insured by a health insurer belonging to the Helsana Group?
  4. What is a liability case (recourse)?
  5. Do I have to bear my share of the costs myself in the event of a liability case (recourse)?
  6. What is hazardous behaviour?
  7. Will my benefits be cut if I exhibit hazardous behaviour?
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Is a tick bite or wasp sting considered an accident?

Yes, tick bites and wasp stings are considered accidents.

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Do I have to bear my share of the costs myself if I have suffered an accident?

Yes, if you have included the accident in your basic insurance policy (compulsory healthcare insurance) . If the accident is covered by the basic insurance policy, you will be billed for your share of the costs. The basic insurance policy will cover the same benefits as illness.

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When can I exclude accident cover if I'm insured by a health insurer belonging to the Helsana Group?

If you are employed and work at least eight hours a week for the same employer, you can exclude accident cover from our policies. In this case, you are subject to compulsory insurance against both occupational and non-occupational accidents from your employer's accident insurer. Non-occupational accidents (NOAs) include accidents suffered on the way to work, while playing sport, during leisure time and at home.

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What is a liability case (recourse)?

If a third party causes you to suffer health-related damage as a result of an act or omission, they are obliged to pay compensation.

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Do I have to bear my share of the costs myself in the event of a liability case (recourse)?

Yes. By law, we are obliged to request that you contribute your co-payment (annual deductible and excess). We recommend that you claim these costs as direct damage from the responsible liability insurance company.

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What is hazardous behaviour?

Hazardous behaviour is construed as actions that expose the insured person to great danger, without limiting the risk to a reasonable degree. You will find a non-exhaustive list at SUVA.

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Will my benefits be cut if I exhibit hazardous behaviour?

In individual cases, we may cut benefits due to "breach of general legal principles". You should therefore expect your benefits to be cut should you act in such a way that is deemed impermissible. In the case of supplementary insurance policies, benefits are excluded for any illness or accidents caused as a result of hazardous behaviour. You will find more information about this in the general insurance conditions for supplementary insurance policies.