If you risk too much when skiing, you also take on a large financial risk. In the case of grossly negligent behavior, the accident 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 deep 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. However, it’s important to know the risks – especially if you are the type that likes speed and adventure. But 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 treatment costs, even if you were skiing off-piste. 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. “If an experienced skier is enjoying the powder by carving a few turns in good weather and has an unfortunate fall, their benefits will not be reduced. However, if an unexperienced 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 Martin Schmid, Head of Accident and Daily Sickness Benefits at AXA.
Although it is rare, 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, tour skiers should only ski off-piste under the instruction of a very experienced guide and on safe and open slopes. This way they can be sure that if any incident occurs, their personal liability insurance will cover any damage – should any accusations be made against them personally.
“During a skiing accident, a lot of factors come together. For this reason, every case is assessed individually,” says Schmid. 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. “It is important to take warnings seriously and adapt the route to your own ability,” Martin Schmid continues.
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 Martin Schmid. Even though there are no speed limits on the pistes, and oftentimes skiers have no idea how fast they are even going down the mountain. “Reason and common sense are the best guides,” Schmid adds.
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 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. Although there are no checks on the slopes, you should not view this as a free pass. Even a little alcohol restricts your vision, meaning that you may overlook other people or dangers on the slopes. 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.”
As a skier, you are liable for any damage you cause to another person, such as accidentally skiing into someone and injuring them. Even personal injury can be expensive – apart from the accident and medical costs, sometimes you may also be liable for the injured person’s loss of earnings if they are unable to work because of the accident. With a personal liability policy, the insurance covers the cost of the claim.
Personal liability insurance also applies if rented skis are damaged or stolen, for example. Skiers, in particular, should make sure that damage caused by gross negligence is also included in their coverage. If not, the insurance company may reduce the claims payment if, for example, you were going too fast on terrains with poor visibility.
If your own skis are stolen, the insurance makes a distinction between theft at home and theft away from home. Theft at home is included in the household contents insurance. If “ordinary theft away from home” is included in the policy, then it will also cover the cost of skis stolen outside the home or at the ski resort. There is normally a deductible of CHF 200 in household contents insurance.
For expensive sports equipment like skis and snowboards, but even mountain bikes or diving equipment, it may make sense to take out sports equipment insurance. This can either be combined with household contents insurance or taken out separately. It generally protects skis/snowboards & co. against theft, loss, and damage, regardless of whether you or someone else were at fault. The insurance also takes effect if the ski breaks after a fall.
If you fall on the piste, your obligatory accident insurance or health insurance covers the costs of the accident and treatment. In Switzerland, if you work more than eight hours per week at a company, you are automatically insured through your employer for non-occupational accidents. With supplementary accident insurance, you can additionally protect yourself against any benefit reductions due to gross negligence or hazardous activity. Self-employed persons, children, students, retirees, and the unemployed must take out accident coverage through their obligatory health insurance. Accident insurance coverage through your health insurance (KVG) means that, in some cases, other provisions may apply compared to accident insurance. For example, health insurance pays 50% of costs for rescue in Switzerland, while accident insurance pursuant to the AIA (UVG) covers the costs in full. For search and recovery, KVG benefits can also be limited to an annual threshold of up to CHF 5,000.