If you risk too much when skiing, you also take on a financial risk. In the case of grossly negligent behavior, the insurance can reduce benefits. That includes not only reckless skiing in deep snow, but also speeding on the slopes or a last run after you’ve already gone to après ski.
Skiing in snow on pristine slopes – it’s not just a thrill for freeriders and tour skiers, but also for many occasional skiers. You shouldn’t have to miss out on the fun. But it is important to know the risks. What risk is still considered reasonable, and when has the line been crossed? And when does insurance pay, when should you expect benefits to be reduced?
The good news: Accident insurance always covers your medical expenses. That includes all costs for rescue, treatment, medication, and transportation. Normally, obligatory accident insurance pays additional cash benefits such as daily benefits. This corresponds to 80% of your salary if you can’t work immediately after the accident. However, if you have entered into too great a risk, the insurance can cut daily benefits due to gross negligence for up to two years or if you have entered into a so-called hazardous activity, then cash benefits, such as pensions, can be reduced or denied altogether.
“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 decisive factors are the weather and snow conditions at the time of the accident, the manner in which the individual was skiing and the hazardous nature of the descent, as well as the equipment, routine, and prior knowledge of the person, and whether avalanche warnings or other warnings had been issued at the time of the accident. “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. Although it is rare, she adds, for those affected it can mean significant and painful financial losses. This is all the more true if a third party is injured in the accident, as even the liability insurance, which generally covers all damage that you cause to others, can cut benefits.
If tour skiers cause an avalanche when skiing off-piste, then they are liable for any damage the avalanche causes, and namely for both property damage and personal injury. Your personal liability insurance bears the costs, unless gross negligence can be proven. This may result in a reduction for gross negligence. Gross negligence is deemed to occur when a person ignores the elementary need to exercise caution. In the case of difficult conditions and in exposed terrain away from safe and open slopes, tour skiers should only ski off-piste under the instruction of a very experienced guide. This way they can be sure that if any incident occurs, their personal liability insurance will cover the damage.
What many people are unaware of: Benefits can also be reduced if your behavior on the slopes is too risky. “Going way to fast or with total disregard is deemed by the accident insurance 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 (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.
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 have alcohol or take the gondola back to the valley after après-ski,” Martina Keller advises.