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Skiing accident: When does insurance pay?

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If you are a daredevil when skiing, you put your health and your money at risk. This is because your insurance company can reduce benefits if a skiing accident was caused by grossly negligent behavior. This includes both reckless deep-snow skiing and also speeding down the slopes. Or a fun descent after too many glasses of mulled wine.

Blue skies, white slopes: Gliding almost silently through the winter countryside, surrounded by the snow-capped mountains, is simply a dream. But unfortunately, things don't always go according to plan. According to the Swiss Council for Accident Prevention (BFU), around 63,000 people are injured while skiing and snowboarding in Switzerland every year. Around 90% of those are self-inflicted accidents, with the remaining 10 percent involving a third person. So winter sports are not without their risks. Caution and consideration on and off the slopes are essential, as is personal liability insurance. We also recommend taking out legal protection insurance. If you take too many risks, you could find yourself in a very unpleasant situation – especially if a third party suffers injury or damage.

Insurance companies penalize gross negligence

After an accident, the first concern is the health of the injured person(s). And that's a good thing. At the same time, every skier and snowboarder should be aware that an accident can also have legal repercussions – including financial consequences. The question of fault is crucial: Was the skier taking too many risks? Was gross negligence involved? If so, insurance companies have the right to reduce certain benefits and require you to foot the bill.

Self-inflicted accidents: Medical costs covered

The good news is that accident insurance always covers your medical expenses. That includes all costs for rescue, treatment, medication, and transportation. However, if the accident victim took excessive risks, the insurance company can reduce daily allowances and disability pensions due to gross negligence. If risks (in German) are taken, the insurance company may not only reduce but even refuse to pay benefits.

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Every skiing accident is an individual incident 

“Whether and how much the benefits are reduced always depends on the exact circumstances. AXA therefore assesses every situation on a case-by-case bases,” says Martina Keller, Head of Accident and Daily Sickness Benefits at AXA. The insurance company takes various factors into account in its assessment:

  • Ability to ski (be careful with drinking alcohol!)
  • Weather, visibility, and snow conditions
  • Skiing style and speed
  • Risk level of the descent
  • Equipment and clothing
  • Routine and previous knowledge of the person
  • Avalanche warnings or other warnings

Liability: avalanche triggered

“However, if a skier leaves the slope when the avalanche risk is high and then gets caught on a snow slab, they must indeed expect reduced benefits,” explains Martina Keller. If third parties are injured, a financial fiasco is almost inevitable. This is because liability insurance can take recourse against the person responsible for the accident in the event of gross negligence. In tricky conditions, ski tourers should therefore only ski under the guidance of a specialist.

Gross negligence vs. risk

If someone acts in a grossly negligent manner, they deviate significantly from the careful behavior that is to be expected. Even more serious are risky acts, i.e. acts in which a person knowingly exposes themselves to a particularly high level of danger without limiting the risk to a reasonable level. In practice, however, it is often difficult to distinguish between these two offenses.

Rules on the slopes

Benefits can also be reduced if your behavior on the slopes is too risky. “Going way too fast or with total disregard is deemed by accident insurance companies to be grossly negligent behavior, even on the piste,” explains Martina Keller. There are no speed limits on the pistes, and oftentimes skiers have no idea how fast they are actually going down the mountain. However, in general: If you gravely disregard the 10 FIS rules (in German) (International Ski Federation), this is considered to be gross negligence, and you may be required to pay for a part of the cost of damages yourself. The FIS rules may not be law, but they are still binding. If the skiing accident leads to court proceedings, the judges use the FIS rules when clarifying the question of guilt, and review if their was any violations based on witness testimony, accident reports, and other evidence.

Après-Ski: No free pass

Skiing after drinking several alcoholic beverages can also be ruled as grossly negligent behavior. Even a little alcohol restricts your vision, meaning that you may overlook other people or dangers. Moreover, people who drink and ski tend to ski faster and overestimate their own ability – a dangerous combination. “Here, too, you should reduce your risk to a reasonable level, and either not consume any alcohol or take the gondola back to the valley after après-ski,” Martina Keller advises.

Tips for conduct out on the slopes 

AXA-ARAG receives a large number of inquiries during the ski season – because it's not unusual for an accident to turn into a legal case. It may be considered controversial, but the burden of proof for the damage generally lies with the injured party. The accident victim must be able to prove how the accident happened. Accompanying persons should therefore take care to record as much information as possible immediately after the accident. To avoid accidents or to behave correctly after an accident, it is best to follow the recommendations set out below:

  • Comply with FIS rules (in German) to protect yourself and others
  • Secure evidence: Take photos, record the contact details of those involved and witnesses, record the details of the accident if necessary, call the police in the event of serious injuries
  • Keep receipts:Note down all expenses and keep receipts until the cause of the accident and fault have been conclusively clarified

Skiing: The following insurance policies are recommended

Personal liability insurance

One of the most important types of insurance when out on the slopes is personal liability insurance. This is because causing damage to a third party can be expensive: In addition to accident and medical costs, the injured person may also suffer a loss of earnings. Please note that personal liability insurance is also compulsory in Italian ski resorts.

Tip: Personal liability insurance also applies if rented equipment is damaged or stolen, for example.

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Accident insurance (mandatory)

If you yourself fall on the piste, mandatory accident insurance covers the accident and medical costs; for those who are not gainfully employed, basic health insurance covers these costs. Accident insurance coverage through your basic health insurance means that, in some cases, other provisions may apply compared to accident insurance. In particular, contributions to transport, search, and rescue operations are limited under basic insurance in terms of percentage and amount. Supplementary outpatient insurance or travel insurance  can be included as a supplement.

Household contents insurance

“Theft away from home” supplement: With this additional coverage, household contents insurance pays for skis or snowboards that are stolen when you are on the go in the ski resort. There is normally a deductible of CHF 200 in household contents insurance.

Additional protection for "bicycles, e-bikes, and sports equipment": This extra coverage insures sports equipment such as skis and snowboards as well as mountain bikes or diving equipment etc. against theft, loss, and damage – regardless of whether it was caused by yourself or a third party. The insurance also takes effect if your skis break after a fall.

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