Accident insurance in Switzerland: what benefits does it pay?

Accident cover includes medical and therapeutic costs after an accident. This includes hospital services and physiotherapy.

some cases, accident insurance also pays for aids that compensate for physical damage, including prostheses and hearing aids, for example.

Are you unable to work after an accident? If so, you will receive daily accident benefits from the third day after the accident. This equates to 80% of your gross salary up to a maximum of 148,200 francs (Art. 22).

You will receive the 80% daily allowance if you are completely unable to work. If you are only partially incapacitated, the daily benefits are reduced accordingly.

Example calculation:

An accident abroad can quickly become expensive. This is because some countries have high medical costs, but the benefits of health insurance and accident insurance are limited.

Outside of EU/EFTA countries, accident insurance will only pay up to twice the amount they would pay for treatment in Switzerland. Within EU/EFTA countries, the local billing practice applies.

Good to know: transport and repatriation benefits are also limited.

In the event of accidents caused by taking part in extreme sports, accident insurance often only pays 50% of the costs – or can refuse to cover the costs completely (Art. 50). This is because you are consciously taking a risk. Rescues are excluded from the rule.

Good to know: you are insured against skiing accidents in Switzerland with your accident insurance. For skiing holidays abroad, the maximum coverage varies by country. However, off-piste skiing is considered an extreme sport.

The costs of rescue operations are not always covered by accident insurance. However, supplemental insurance will cover the costs in some cases.

Important: contributions to Rega are not considered as having taken out insurance. As a result, there is no guarantee that the costs of Rega operations will be covered.

Is your gainful employment likely to be impaired in the long term after an accident? If so, you will receive an invalidity pension from the accident insurance. This amounts to 80% of the insured earnings in the event of full invalidity. If you suffer from only partially invalidity, the pension will be reduced accordingly.

Prerequisites: medical treatment no longer improves your health condition. In addition, the rehabilitation measures provided under the invalidity insurance must be completed.

Accident insurance also covers other benefits:

• Damage to integrity: "integrity" is classed as the intactness of a person's physical, mental and psychological health. You no longer have complete integrity if, for example, you go blind or lose a body part. In this case, you are entitled to lump-sum benefits.

• Helplessness allowance: are you dependent on the help of others due to your invalidity? If so, you are entitled to a helplessness allowance.

• Survivor's pension: the right to a survivor's pension arises if a person dies as a result of an accident. It can usually be claimed by children and spouses.

Further information is available from the Federal Office of Public Health (FOPH).