What to do in the event of an accident?
Accidents take place within seconds – and often they change lives forever. That of the victim as well as the whole family. Their future must remain financially affordable as well.
Am I insured against accidents?
If you work for the same employer for at least 8 hours a week, then you are insured against occupational and non-occupational accidents as well as occupational illnesses. The Swiss federal law on accident insurance (UVG/LAA/LAINF) applies. In the event of an accident, you will receive the statutory benefits from this insurance.
It is an entirely different matter if you are not employed or are employed less than eight hours per week at the same employer. Then you are only insured against occupational accidents and occupational illnesses through the obligatory accident insurance. You must therefore include the accident cover in your health insurance. That way, you are also insured in the event of a non-occupational accident.
Which benefits does the accident insurance pay pursuant to Swiss federal law on accident insurance (UVG/LAA/LAINF)?Accident insurance providers pursuant to the UVG/LAA/LAINF must bear the total costs in the event of an accident for
• outpatient and inpatient curative treatment (general ward)
• medical aids
• participation towards travel and transport costs as well as further costs
• daily allowance (up to 80 % of the last salary, from the 3rd day after the accident
• compensation for damage to integrity
• helplessness allowance
• survivors’ pensions or settlement
• disability pension
You do not pay the deductible nor must you participate in the costs in the form of a retention fee. The daily allowance will be paid out to you until your recovery. The obligatory accident insurance also assumes costs for relapses and long-term consequences of accidents.
The hospital or your doctor shall send all invoices directly to the insurance provider. You must therefore neither pay the invoices yourself nor send them to your insurance.
Which benefits are taken over by the accident cover of the health insurance pursuant to the KVG/LAMal?In the event of an accident, the accident cover of the health insurance does not cover the same benefits as the accident insurance pursuant to the UVG/LAA/LAINF.
The health insurance, just like the accident insurance, takes over the treatment costs, but invoices the deductible and retention fee as it does with illness. You must, however, pay the deductible only one time per calendar year for illness and accident together. The health insurance makes, in particular, no distinction between illness and accident. The retention fee is limited to a maximum of CHF 700 per year for illness and accident together.
A further distinction exists with cash benefits. There is no entitlement to daily allowance with the accident insurance of basic insurance. Just the same, no disability pension nor death benefits will be paid out. A compensation for damage to integrity is only paid through the accident insurance.
How do I report an accident?
If you are insured through your employer pursuant to the UVG/LAA/LAINF, your employer will take over reporting the accident. Inform them of the accident's exact sequence of events so that they can forward the necessary information to the insurance provider.
If you are insured with the accident cover of obligatory health care insurance (OKP/AOS/AOMS), then you must report the accident yourself with this form (in German).
• Please fill out all the fields required.
• Create a PDF and print it out.
• Sign it.
• Send it to your CONCORDIA agency.
This report must be made as soon as possible.
What counts as an accident?An accident is an event which, due to a sudden, involuntary damaging effect of an unusual external factor on the human body, results in an impairment of physical or mental health or death.
If, in case of physical or mental impairment, the accident requirements aren't met, the case is generally considered to be an illness and your basic insurance pays. You will thus receive illness benefits.
My accident insurance doesn’t pay. What can I do?If the accident insurance does not pay the benefits, and thus the impairment is not classified as an accident, then the insurance provider must on demand communicate this in a decree in written form. If you do not agree with this, you may file an objection within 30 days.
I have been unable to work for a prolonged period of time. What should I bear in mind?You will be assigned a contact person by the accident insurance provider. This person will oversee your case and help you should you have questions. Furthermore, you will receive an ‘incapacity to work’ card, which you must take with you to doctor appointments. The doctor must enter the percentage of your incapacity to work each time on the card. Send this card once a month to your employer.
You will receive financial support up until the end of your recovery, provided the benefit requirement are met. The amount of the daily allowance depends on the percentage of your incapacity to work.
What should I bear in mind in the event of an accident abroad?A maximum of twice the amount that would be paid in Switzerland for the same treatment will be compensated. If you would like to make use of more benefits, you can take out Vacation and Travel Insurance. With this, the recovery costs will be taken over at the local rate. With DIVERSA Supplementary Insurance and PRIVATE Hospital Insurance too, you are better insured when abroad. Should you have any questions, please contact your CONCORDIA agency.
Can I insure myself additionally against accidents?
My child had an accident and must be hospitalised. Can I stay with her/him in the hospital?If your child has an accident, you may spend the night with her/him in the hospital. In the case you yourself have an accident, you may also take your infant, for example, in the hospital with you.
CONCORDIA pays a maximum of CHF 60 out of the supplementary insurance DIVERSAcare and CHF 100 out of DIVERSApremium per night of the stay of the accompanying parent in the hospital where the child (until the age of 10) is staying or vice versa (max. ten nights per calendar year).
In addition, CONCORDIA pays out of all supplementary hospital insurances a contribution of a maximum of CHF 60 per day towards the stay of the accompanying parent in the hospital where the child is staying or vice versa. It is irrelevant whether the person insured has taken out PRIVATE, SEMI-PRIVATE, LIBERO or GENERAL Hospital Insurance.