Work-related accident

What is a work-related accident?

A work-related accident (Berufsunfall) is an accident that happens to an employee at work. Under Art. 7 of the Accident Insurance Act (UVG), this includes any accident during work carried out on the employer’s instructions or in the employer’s interest, and any accident during breaks and before and after work if the employee is lawfully on the work premises or in the area of occupational hazards.

What counts as an accident is defined in Art. 4 of the Federal Act on the General Part of Social Insurance Law (ATSG): the sudden, unintentional harmful effect of an unusual external factor on the body. In addition, accident insurance covers certain bodily injuries such as bone fractures, dislocations and torn menisci, muscles and tendons, even without an unusual external factor, provided they are not mainly due to wear and tear or illness (Art. 6 para. 2 UVG).

The counterpart is the non-work-related accident (NBU) in your free time, during sport or at home. Both are part of compulsory accident insurance under the UVG. An illness caused by work is not an accident, but it can be treated in the same way as a work-related accident as an occupational disease.

How it works

Every employer must insure its employees against work-related accidents, with Suva or with another authorised accident insurer. Art. 66 UVG specifies which businesses belong to Suva, for example industrial, construction and forestry businesses. The employer alone pays the premium for work-related accidents. It may deduct the premium for non-work-related accidents from your salary.

After a work-related accident, the process is as follows:

1. Report: you report the accident without delay to your employer or the insurer. Your employer reports it to its accident insurer.
2. Medical treatment: accident insurance pays for appropriate treatment: outpatient treatment, hospital treatment in the general ward, medicines, therapies and aids and appliances. You choose your doctor and hospital freely.
3. Daily allowance: from the third day after the day of the accident, you receive 80% of your insured earnings if you are fully unable to work, and correspondingly less if you are partly unable to work. For the waiting period, your employer pays at least four fifths of your salary (Art. 324b para. 3 of the Code of Obligations, CO).
4. Long-term consequences: if a degree of invalidity of at least 10% remains, accident insurance pays an invalidity pension.

Basic health insurance is secondary in the case of a work-related accident. It only steps in if no accident insurance pays, and it must pay in advance if it is unclear whether the case is an accident or an illness (Art. 70 ATSG).

Legal basis

Art. 1a UVG makes all employees working in Switzerland subject to compulsory accident insurance. Art. 7 UVG defines the work-related accident and Art. 8 UVG the non-work-related accident. For part-time employees, Art. 13 of the Ordinance on Accident Insurance (UVV) sets the threshold at 8 hours a week for one employer: below that, there is only insurance against work-related accidents, and accidents on the way to and from work count as work-related accidents. The benefits are set out in Art. 10 (medical treatment), Art. 16 and 17 (daily allowance) and Art. 18 UVG (invalidity pension), and the maximum insured earnings of CHF 148,200 in Art. 22 para. 1 UVV. Art. 91 UVG governs the obligation to pay premiums.

For health insurance, Art. 1a para. 2 let. b of the Federal Health Insurance Act (KVG) applies: it only covers accidents to the extent that no accident insurance pays. Under Art. 64 para. 2 ATSG, accident insurance takes precedence over health insurance for medical treatment. If you are fully insured under the UVG, you can suspend the accident cover with your health insurer (Art. 8 KVG); the premium falls by the accident share, by a maximum of 7% (Art. 91a para. 4 of the Health Insurance Ordinance, KVV).

Example: a fall in the workshop

Nora, 34, works full-time as a carpenter with an annual salary of CHF 78,000. She falls in the workshop and breaks her wrist. She is fully unable to work for four weeks.

What this means for you

• Check your accident cover: if you work at least 8 hours a week for the same employer, you can suspend the accident cover with your health insurer. Suspend accident cover shows whether it is worthwhile.
• Report an accident immediately: a late report makes it harder to establish whether it was an accident.
• Act when you change or lose your job: if your accident cover under the UVG ends, you must include accident cover with your health insurer again. You compare premiums with and without accident cover in the premium calculator.
• Compare insurers: you will find the key figures for the insurers under Health insurers. More on accident insurance under UVG.

Common mistakes

• Reporting an accident at work to your health insurer. Your employer’s accident insurer is responsible; the health insurer only pays on a subsidiary basis.
• Misjudging part-time work. If you work less than 8 hours a week for the same employer, you are not insured against leisure accidents; you then need accident cover with your health insurer.
• Forgetting to end the suspension. When your employment ends, UVG cover lapses once the extended cover period has expired.
• Reporting an illness as an accident. Back pain without an external event is usually not an accident; in that case, your health insurer pays, with the deductible and retention fee.