Mandatory insurance required under the accident insurance law Accident insurance

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Key points at a glance
  • Legal obligation: Employers are required to insure their employees against the consequences of accidents and occupational diseases.
  • Comprehensive protection: Accident insurance protects you and your employees against the financial consequences of an accident and covers the costs of medical treatments, continued salary payments and pensions.
  • Attractive added benefits: Supplemental accident insurance can be taken out to expand mandatory accident insurance coverage with additional benefits such as private rooms in hospitals and lump-sum payments in the event of disability and death.

What is mandatory accident insurance?

Mandatory accident insurance is a type of occupational accident insurance. It covers costs that arise due to occupational and non-occupational accidents and occupational diseases. The principles of mandatory accident insurance are based on the Accident Insurance Act, which clearly defines the insurance coverage and benefits.

Under the Accident Insurance Act, employers are required to insure their employees against the consequences of an occupational accident and to report any such accidents to the accident insurance provider without delay. Non-occupational accident insurance is also required for any employees who work at least eight hours per week. 

Occupational accident, occupational disease or non-occupational accident?

Any accident that occurs while someone is doing their job or on a break at work or immediately before or after their working hours is regarded as an occupational accident. Any disease that is mainly attributable to a person’s job – e.g. as a result of inhaling harmful substances – is regarded as an occupational disease. Accidents during free time while taking part in sports, at home or in traffic are regarded as non-occupational accidents.

Who should have statutory accident insurance?

Whether your company employs people full-time or part-time, whether you have interns, trainees or people who help you with your work in your own home, accident insurance is a legal requirement for all staff. Coverage begins on the first day of employment, i.e. the first time the employee travels to work.

Even unemployed people are subject to mandatory accident insurance. But they are automatically covered by accident insurance for unemployed persons.

Good to know: If someone with more than one employer has an accident, they must clarify which employer’s accident insurance covers it. The deciding factor is where the person was last working before the accident and to what extent the insurance covers non-occupational accidents.

What benefits does mandatory accident insurance include?

The benefits offered by mandatory accident insurance are defined by law in Switzerland. AXA reliably pays out all the required benefits to ensure that your company’s staff are comprehensively covered for accidents at work or on the way to or from work as well as occupational diseases.

As an employer, you can also benefit from accident insurance as provided for under the law on accident insurance. In addition to covering the financial impact of an accident for your company, we offer you efficient, individual coordination of benefits together with useful services that save you time and stress when accidents occur.

The scope of benefits for mandatory accident insurance includes:

  • Outpatient treatment (treatment costs) by a doctor as well as medical personnel
  • Prescribed medications and examinations
  • Necessary travel, transportation and rescue costs
  • Inpatient treatment in the general hospital ward
  • Medical aids to assist with physical impairments (e.g. prosthetics)
  • Necessary medical treatment abroad
  • At-home care and assistance
  • Expenses for transporting the body and the funeral

Basic insured benefits

Added to these benefits are continued salary payment in the form of daily benefits and further financial benefits in line with the insured salary. The sum insured is based on the maximum annual salary of CHF 148,200 per person under the accident insurance law. For salaries exceeding this amount, the difference can be insured through supplemental accident insurance.

The following cash benefits are paid out under mandatory accident insurance:

  • Daily benefits: The entitlement to daily benefits begins on the third day after the accident. Insured persons receive 80% of their salary if they are entirely unfit for work or a lower percentage if they are partially unfit.
  • Disability pension: If an accident leads to a permanent or long-term disability, the person affected is entitled to receive a disability pension. The degree of disability determines the amount of disability benefits to be paid. If the person is fully disabled, daily benefits amount to 80% of insured earnings. This amount is reduced accordingly for partial disability. The sum of benefits from statutory old age and disability pensions may not exceed 90% of insured earnings.
  • Survivor's pension: If an employee dies due to an accident, the surviving family members are entitled to a death benefit in the form of a survivor’s pension. This is calculated as follows:
    • 40% of the insured earnings for widows and widowers
    • 15% of the insured earnings for each half orphan who has lost one parent
    • 25% of the insured earnings for each orphan who has lost both parents
    • max. of 70% of the insured earnings for several survivors together
    • max. 90% of insured earnings when added to statutory old age/disability pensions
  • Impairment compensation: If an accident leads to a permanent impairment (e.g. through the loss of a limb), impairment compensation is paid out as a one-time lump sum in line with the percentage of impairment.
  • Helplessness allowance: Anyone who must rely on permanent help due to the lasting consequences of an accident receives a helplessness allowance.

Reduction and refusal of insurance benefits

If weighty reasons or gross negligence is involved, the insurance benefits for an accident may be reduced or refused altogether. Some examples include:

  • Speeding
  • Driving under the influence of alcohol or drugs
  • Active participation in a physical altercation

AXA supplemental accident insurance customers benefit from these services

  • Teaser Image

    WeCare gives your company access to a wide range of services and professional assistance in the areas of prevention and reintegration, which enables you to improve the well-being of your employees and in this way avoid long-term absences.

    More about WeCare
  • Teaser Image
    Accident Card

    Thanks to the Accident Card, your employees have all the necessary information quickly to hand in an emergency abroad: This service is provided free of charge to AXA customers with mandatory accident insurance coverage. Your AXA contact person will be happy to order some for you.

Accidents abroad

Mandatory accident insurance will step in even in the unhappy event that an accident occurs outside of Switzerland. This coverage gives your employees solid basic protection, but there are two restrictions:

  • It only pays out twice the amount of what the accident would have cost if it had occurred in Switzerland instead of abroad.
  • If any expenses involving rescue, retrieval, travel or transportation abroad are incurred, no more than one fifth of the maximum amount of CHF 148,200 of the insured annual salary will be refunded. 

Especially for business trips to countries with costly healthcare systems, such as the US or Canada, it is advisable to take out additional insurance coverage. Supplemental accident insurance from AXA will give you the best coverage possible.

Remember that a payment guarantee from the accident insurer is generally required for treatment abroad following an accident. This allows foreign treatment providers to ensure that the treatment costs incurred will be covered in each individual case.

In such cases, the Accident Card from AXA can help you out: You and your staff can reach AXA round the clock at the telephone numbers listed and receive immediate preauthorization for basic coverage. Your staff are thus well protected at all times while abroad and will receive rapid assistance should the worst happen.

Support and FAQs

  • Who pays the premiums for accident insurance?

    Employers are liable for the entire premium and bear the share of it that covers occupational accidents and diseases. As a rule, employees bear the share for non-occupational accidents via a salary deduction.

    If a collective bargaining agreement exists, then in many cases the employer must pay for half of the premiums for non-occupational accidents. For companies that do not have a collective bargaining agreement, the employer can decide whether they would like to help pay for some of the costs.

  • How are “accident” and “disease” defined in this context?

    Accident insurance covers accidents and occupational diseases. Non-occupational diseases are in principle covered by employees’ health insurance. For the insurer to accept an accident report and pay out, the accident in question must involve an unusual, unintended and sudden effect on the human body from an external factor.

  • Am I insured against accidents on my way to work if I only work two hours per week at a company?

    Yes. Employees are covered by mandatory insurance against occupational accidents and occupational diseases, whatever their working hours. This includes the journey to and from work from leaving home until returning directly home.

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