Accident insurance

If you're an employer, you're obliged to insure your employees against accidents. If employees suffer accidents or occupational illnesses, this can have serious consequences for their everyday life and work. Compulsory accident insurance alleviates these consequences by providing sound basic financial benefits. In addition to compulsory accident insurance, Helsana Business Salary also provides supplementary accident cover. You can add to the statutory benefits as needed.

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We'll analyse your situation and your needs and sit down with you to work out the best possible solution together.

Benefits for your company

Modular structure

The benefits under compulsory accident insurance are fixed – but, when you complement it with supplementary accident insurance, it is you and you alone who decides which services you want to claim and which risks you want to cover.

Relief of the administration

We deal with administrative tasks, such as enquiries into conditions of eligibility for benefits, quickly and professionally. We also support you in communication with other stakeholder institutions, such as the disability insurance office and thus saving your organisation time and effort.

You are comprehensively insured

You and your employees are comprehensively insured against the consequences of accidents, whether these are medical expenses, lost earnings or permanent incapacity to work.

Prevention cuts costs

As one of the biggest health insurers in Switzerland, we help you with every aspect of health management – from health promotion to absence management.

All-round care

Helsana offers you all-round care of a kind only few other insurers can. We take preventive action and help you with additional benefits if you so request. We also support you and your employees as they return to regular work.

Do I have to take out accident insurance?

All employees working in Switzerland must be insured against accidents. If you are not self-employed or insured by Suva (the Swiss National Accident Insurance Fund), you are required by law to take out compulsory accident insurance for your employees.

Compulsory accident insurance covers your employees against the consequences of an accident that occurs at work, not at work or occupational illness. Supplementary accident insurance enables you to offer your employees protection over and above the obligatory minimum.

Insurance obligations and options in the event of an accident

Compulsory

Voluntary

Medical expenses

Doctor's bills and hospital bills

Medical treatment / other benefits in kind

general hospital ward

Other costs covered by insurance

private/semi-private hospital ward

Incapacity for work

Salary during the absence from work

Daily allowance

80 % of the insured income- max. CHF 148,200 - from the third day after the accident date 

Additional daily allowance

Any daily allowance supplement up to 100 % of the full salary

Occupational disability

Living expenses in case of disability

Pensions / compensation

80% of the insure income - max. CHF 148,200

Additional pensions/compensation

Any supplements up to 100% of the full salary

Which benefits are insured?

The benefits payable under compulsory accident insurance are laid down by law. They cover medical expenses, a hospital stay in a general ward and 80% of lost earnings (where the salary does not exceed CHF 148,200). Helsana Business Accident offers you options over and above this compulsory accident insurance. These additions can all be adapted to your needs in modular fashion, independently of one another.

Situation with an accident insurance

Benefits from last salary in % 

Graph showing the interaction of accident insurance, supplementary accident cover and social insurance

As an employer, you're obliged to continue to pay at least 80% of an employee's wages from the day of their accident. They become entitled to benefits from compulsory accident insurance from the third day after the accident. That entitlement lapses once the employee is fully recovered and capable of working.

What compulsory accident insurance offers your employees and their family members is financial security after an accident or in the event of disability or even death. It aims to secure their standard of living.

Compulsory accident insurance covers occupational and non-occupational accidents and occupational illnesses.

Occupational accidents are defined as all accidents occurring during working hours. The category also includes accidents sustained before and after work, provided that they are linked with work in some way. It follows that accidents on the way to work are always covered by insurance. Part-time employees working fewer than eight hours a week are covered only in respect of occupational accidents. Accidents sustained by them on the way to work are counted as occupational, while they are non-occupational in the case of all other employees.

Under the UVG, illnesses are treated as occupational in nature if they were brought on in the course of occupational activity mainly or entirely by harmful materials or certain types of work. The insurance also covers illnesses that can be demonstrated to have been brought on solely or very largely by the work done.

Persons insured under obligatory accident insurance are entitled, depending on the circumstances of the individual case, to medical expenses, daily benefits, disability pensions, integrity compensation, helplessness benefits and survivors' pensions.

Medical expenses relate to necessary medical treatment of the consequences of accidents. They also cover the cost of aids to compensate for physical injury, damage to property, and the costs incurred in travel, transportation, rescue, recovery and burial/cremation.

Daily benefits are paid as from the third day after the accident, amounting to no more than 80% of the insured earnings. Insured persons who are completely incapable of working receive the maximum amount. Those who are capable of work to some extent received benefits that are reduced proportionately.

Persons who have become at least 10% disabled as a result of an accident can claim a disability pension. Disability pensions amount to 80% of insured earnings for persons who have become completely incapable of work, and are reduced proportionately where the incapacity is partial.

Anyone whose physical, mental or emotional integrity is substantially and permanently impaired as a result of an accident is entitled to integrity compensation. This compensation takes the form of a one-off payment calculated by reference to the maximum insured earnings and not exceeding it.

A person who has had an accident as a result of which they are disabled and need the help of others to cope with everyday living receives a helplessness benefit. This benefit is paid monthly and is equivalent to at least twice, but no more than six times, the maximum amount they could earn in a day.

On the insured person's death, the surviving family members can claim a survivors' pension. The spouse gets 40%, full orphans 25%, and half-orphans 15% of the insured earnings. All the survivors taken together, though, can receive no more than 70% of the insured earnings in total.

Spouses are entitled to a pension only if they have children who are themselves entitled to one or live with such children in a joint household. In addition, spouses who are at least two-thirds disabled or become so within two years of their spouse's death are entitled to a survivor's pension.

Unlike a widower, a widow is entitled to a pension if she is over 45 years of age or has children who are no longer entitled to a pension. The insurer may, moreover, pay the widow a one-off settlement even if she meets none of the conditions that would entitle her to a pension.

Supplementary accident insurance enables employers like you to add modules to this compulsory accident insurance, and on all three levels: treatment, daily benefits and long-term loss of earnings. The possibilities are many and varied: you can, for example, insure lower wages more generously (100% rather than only 80%) or insure higher salaries above the CHF 148,200 limit imposed by the UVG on insurable earnings. You can also raise the level of accommodation in hospital not only for certain groups of employees but for all of them, from general to semi-private or private.

Medical expenses

After an accident, your employees will benefit from medical treatment, food and accommodation in a hospital's semi-private (2-bed) or private (single-bed) ward. They also have a free choice of physician while in the hospital.

Daily hospital benefits

Your supplementary accident insurance can also include a daily hospital benefit payable to the insured person to the agreed amount while they are in hospital. They can also receive this benefit during convalescent therapy prescribed by a physician or while being cared for at home by a third party who takes care of the household. This enables them to cover any costs they may incur.

Daily benefits

If an employee is certified by a physician to be temporarily incapable of work, Helsana will pay daily benefits of up to 100% of the employee's real salary, starting from the day of the accident, rather than from the third day after it. This will be of particular interest to employees whose salary exceeds the maximum under the UVG of CHF 148,200. Only supplementary insurance will enable these people to have daily benefits sufficient to maintain their accustomed standard of living.

Capital insurance

You can insure up to 600% of your employees' real wages. The insured capital will be paid out to them or to their surviving relatives in the event of their disability or death.

Pensions

In the event of disability or death, employees or their surviving relatives receive pensions from compulsory accident insurance, but only up to the maximum salary under the UVG. Supplementary accident insurance calculates these pensions on the basis of their real wages. This helps employees who earn more than the UVG maximum to maintain their standard of living.

On the insured person's death, the pensions are paid to the survivors entitled to them, the surviving spouse taking precedence, the insured person's children coming second, and their parents third in line.

Special risks

Where an accident was caused by gross negligence, exceptionally dangerous activities or hazardous behaviour (e.g. taking part in a motocross race), compulsory accident insurance may reduce benefits or refuse outright to pay them. Supplementary accident insurance, on the other hand, can cover these special risks.

Deliberate acts are, however, still excluded. They result in benefits being reduced or withheld in supplementary accident insurance, too.

Cover for costs incurred abroad

Compulsory accident insurance imposes limits on the payment of costs for travel, transport, rescue, the transport of human remains and burial, where these are incurred abroad. It repays no more than twice the amount that the same service would have cost in Switzerland.

Supplementary accident insurance enables you to increase this foreign cover. If you're insured for treatment in a semi-private or private ward, the insurance will cover this when you're abroad too. The person who has suffered an accident will be cared for abroad until such time as they can be brought back to Switzerland.

Answers to frequently asked questions about accident insurance

If an employee becomes incapable of work, you, as an employer, are obliged to continue to pay at least 80% of their wages from the day of their accident. Not until the third day after the accident does compulsory accident insurance take over and start paying daily accident benefits. In the event of permanent incapacity to work, state disability insurance (IV) benefits complement accident insurance payments, if necessary until the day your employee retires. After retirement, the payments in lieu of salary are replaced by the AHV pension. 

If the insured person is completely unable to work, they will receive 80% of the insured salary. In cases of partial incapacity for work, the amount is reduced pro rata.

With compulsory accident insurance, the maximum insured annual salary is CHF 148,200. The maximum possible daily benefit is therefore CHF 324.80: 80% of the maximum UVG salary divided by 365.

Supplementary accident insurance can be taken out to cover the salary component that exceeds the CHF 148,200 ceiling.

Your accident insurance and supplementary insurance are valid worldwide.

If you are involved in an accident while abroad, the compulsory insurance will cover up to a maximum of twice the cost of the same benefit in Switzerland. Even better terms apply to EU and EFTA countries.

If you are insured for treatment in a semi-private or private ward, the insurance will cover those costs when you're abroad too.

Whatever happens, if you have an accident while abroad, you are entitled to medical care and treatment until you can be repatriated to Switzerland. All subsequent medical treatment will then be provided in Switzerland.

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