Accident Insurance in Switzerland Explained

This moneyland.ch guide explains the different kinds of Swiss accident insurance, who they are for, and the coverage included in each.

Is accident insurance mandatory in Switzerland?

Yes. Like basic health insurance, basic accident insurance that covers the costs of medical care is mandatory for all Swiss residents. Depending on your situation, you get this obligatory insurance either with your health insurance provider, through your employer, or directly from an accident insurance provider.

Are accidents covered by mandatory Swiss health insurance?

In Switzerland, a difference is made between illnesses and accidents. Mandatory Swiss health insurance covers costs related to illnesses. The costs of treating injuries that result from accidents are covered by separate accident insurance. However, you do get mandatory accident insurance through your mandatory Swiss health insurance provider in some cases.

How am I insured against accidents in Switzerland?

Which insurance applies to you depends on whether you are employed, self-employed, unemployed, or not employed (including children and retired people).

• Mandatory health insurance (KVG/LAMal)

If you are not employed and do not receive Swiss unemployment benefits, you must add basic Swiss accident insurance coverage to your mandatory health insurance policy. All Swiss mandatory health insurance providers offer this insurance rider. This requirement also applies to children and retired people.

Your mandatory health insurance provider charges you additional insurance premiums for accident insurance. Premiums are charged along with your health insurance premiums. Note: Technically, compulsory accident insurance is bundled with mandatory health insurance by default, and you receive a discount off your health insurance premium when you put it on hold.

• Employer-based insurance for accidents in the workplace (OAI)

If you are employed by a Swiss company, your employer is required to get occupational accident insurance for you from their accident insurance provider. This insurance only covers accidents that happen in the workplace.

This insurance does not cover accidents outside of the workplace, so you must remain insured by your mandatory health insurance provider or by NOAI insurance from a different employer.

Your employer pays the premiums for OAI insurance.

• Employer-based insurance for accidents outside the workplace (NOAI)

If you work for a Swiss company more than eight hours per week, your employer must also get you additional accident insurance for accidents that happen when you are not at work. This insurance is provided by your employer’s accident insurance provider.

Having this insurance replaces the need for the accident insurance from your mandatory health insurance provider. If you have NOAI insurance, you should put the accident coverage from your compulsory health insurance provider on hold (or exclude it when getting a new health insurance policy) to avoid paying for it unnecessarily.

You are required to pay the premiums for NOAI insurance yourself, unless your employer chooses to cover them as a special employee benefit. They are normally deducted from your salary by your employer. Premiums vary depending on the kind of work your company does and other factors.

• Voluntary accident insurance

If you are self-employed and do not also work for an employer, then you are not subject to OAI or NOAI accident insurance. In this case, you can voluntarily take out private accident insurance that is equivalent to the OAI and NOAI. Voluntary OAI/NOAI-equivalent accident insurance is offered by many Swiss insurance providers.

Exception: If you are an employee of your own company, as is often the case with AG/SA companies, then must choose an OAI/NOAI accident insurance provider and get insurance for yourself just as you would for other employees.

You pay the premiums for voluntary accident insurance yourself. If the work you do puts you at risk of accidents, then the premiums you pay for voluntary insurance can be very high.

If you choose not to get voluntary OAI/NOAI-equivalent accident insurance when you become self-employed, you must activate the basic accident insurance from your mandatory health insurance provider (KVG/LAMal).

Table 1: Overview of Swiss accident insurance types

How can I claim accident insurance benefits?

If you get accident insurance from your health insurance provider (KVG/LAMal), you simply file a claim as you would with other medical bills.

If you get accident insurance through your employer (OAI/NOAI), then the process is often more complicated. Taking these two steps when an accident occurs will prevent issues with claiming insurance benefits:

• Inform your employer about the accident as soon as possible so that they can inform their accident insurance provider. 
• Inform Swiss healthcare establishments where you receive treatment that the costs must be billed to your employer’s accident insurance provider. The processes for accepting and billing patients are different from those for health insurance for illnesses.

OAI and NOAI insurance uses direct settlement (tiers payant). That means you do not have to pay bills in advance and then claim reimbursement. If medical bills are sent to you, you should forward them to your employer so they can claim benefits.

Does Swiss accident insurance cover me when I travel outside of Switzerland?

Yes. However, coverage for treatments abroad differs from coverage for medical care in Switzerland.

In EFTA and EU countries, the UK, and some other European countries, the medical care, costs, and deductibles of the country’s public healthcare system apply, as with health insurance coverage for treatments in the EU, EFTA, and the UK.

In all other countries, these limitations apply to Swiss accident insurance coverage:

• Coverage for emergency medical care outside of Switzerland is limited to double the cost of getting the same treatment in Switzerland.
• Coverage for search, rescue, and ambulance transportation outside of Switzerland is limited to one-fifth of your insured salary.

Are all accidents covered by mandatory Swiss accident insurance?

Accidents are generally covered by accident insurance. However, your accident insurance provider can pay out reduced insurance benefits when an accident is caused by gross negligence on your part. The insurance company can also pay lower benefits if the accident occurs as a result of you taking excessive risks, such as participating in certain extreme sports.

If another insurance – such as third-party liability insurance for cars – is primarily responsible to cover your costs and losses, then accident insurance only extends the benefits you get from that insurance. That also applies to loss-of-income benefits and pensions.

Is my full salary insured by OAI and NOAI accident insurance?

Only the portion of your salary that does not exceed 148,200 francs per year is insured by compulsory Swiss accident insurance. If you earn more than 148,200 francs per year, the portion of your salary above that threshold is not insured by mandatory accident insurance. The loss-of-income benefits, disability pension, and survivor’s pensions are calculated based on the insured portion of your salary only.

However, employers can choose to get optional, additional accident insurance for their employees on top of the basic insurance required by law.

Supplemental employer-based accident insurance may extend the loss-of-income benefits and disability pensions to cover 100 percent of your insured salary, or even your actual salary (if you earn more than 148,200 francs). This can be beneficial if 80 percent of your insured salary would not cover your budget. It may also extend the survivor’s pensions that your dependents would receive if you were to die in an accident.

Supplemental insurance may also provide better coverage for hospital stays to include semi-private or private wards. It may also and/or include higher coverage for emergency medical care outside of Switzerland. Some supplemental accident insurance offers and riders make up the difference if your mandatory accident insurance benefits are reduced due to gross negligence or taking excessive risks (extreme sports, for example).

Typically, you as the employee must cover the cost of supplemental accident insurance premiums. However, employers may choose to pay the premiums for you as a special employee benefit.

Take time to review your employer’s accident insurance plan. Check whether any supplemental accident insurance is included, and what is covered.

Can I get additional accident insurance?

Yes. Extended coverage for emergency medical care required because of an accident is included in voluntary, supplemental outpatient insurance and hospital insurance offers. Additional insurance for medical emergencies in other countries is also included in some Swiss travel insurance offers.

If you earn an income, you also have the option of getting additional, private disability insurance. This is worth considering if the loss-of-income benefits and disability pension you would get from your employer’s accident insurance do not adequately cover your income. You can choose to exclude illnesses and limit coverage to accidents only, in which case the premiums you pay are much lower. Disability insurance is generally offered in either the pillar 3a or pillar 3b categories.

Which accident insurance applies if I am unemployed?

When you receive Swiss unemployment benefits, the unemployment insurance office takes out NOAI accident insurance for you from Suva, its accident insurance provider.

If you remain unemployed after the unemployment benefit term ends, you must activate the accident coverage from your mandatory health insurance provider.

Alternatively, you have the option of getting interim accident insurance for up to six months from the time your unemployment benefits end. This voluntary insurance, which is offered by OAI/NOAI insurance providers, has the same benefits as NOAI insurance.

Which accident insurance applies to self-employed people?

If you are an employee of your own company, as is generally the case with AG/SA companies, then must choose an OAI/NOAI accident insurance provider and get insurance for yourself just as you would for other employees.

If you have a sole proprietorship or other type of company in which you are an owner or partner rather than an employee, then you are not subject to obligatory OAI/NOAI insurance. Many accident insurance providers offer voluntary accident insurance that is identical to OAI/NOAI insurance. If you do not want this voluntary accident insurance, you must use the basic accident insurance cover from your mandatory health insurance provider (KVG).

Which accident insurance applies to ANobAG employees?

If you live in Switzerland but work for employers in countries that do not have social security agreements with Switzerland, the social security office may classify you as an ANobAG employee. ANobAG employees are required to have OAI and NOAI accident insurance. You can subscribe to a Swiss accident insurance provider on your foreign employer’s behalf. If you are unable to find an insurance company that accepts your application, you must contact the Ersatzkasse UVG, which will assign an accident insurance provider to you.

Can I keep my Swiss accident insurance if my employer sends me abroad?

Employees of Swiss employers who are temporarily stationed outside of Switzerland by their employer remain subject to OAI and NOAI accident insurance for the first two years of their foreign assignment. The insurance term can be voluntarily extended for up to four more years upon request.

More on this topic:
Swiss mandatory health insurance comparison
Swiss disability insurance explained
Swiss unemployment insurance explained
Interim accident insurance explained
Paid sick leave in Switzerland: A complete guide
Swiss mandatory health insurance coverage explained