Is the employer obliged to continue paying salaries in the event of an inability to work due to an accident?
The obligation to continue to pay salaries in the event of accidents is governed by Article 324a and b of the Swiss code of Obligations (OR). In Switzerland, it is mandatory to insure all employees against accidents. If the employer is obliged to continue paying salaries, he must pay the injured person 80 percent of his salary during the waiting period of two days after the accident (Art. 324b para. 3 OR). From the third day onwards, the mandatory accident insurance (LAI) will step in and pay a daily allowance amounting to 80 percent of the salary.
For how long is a daily allowance paid out as a result of an accident?
The mandatory accident insurance (LAI) provides for a daily allowance of 80 percent of the insured salary. Entitlement to a daily allowance starts on the third day of inability to work and ends when full capacity for work is regained, a pension begins or death occurs. The maximum insured salary is currently 148,200 Swiss francs.
Does the obligation to continue to pay salaries apply from the first day of work in the company?
This depends on the employment relationship that has been entered into. Article 324a of the Swiss Code of Obligations (OR) provides that the obligation to continue to pay salaries arises if the employment relationship "has lasted more than three months or has been entered into for more than three months".
What events are considered accidents?
The Federal Law on the General Part of Social Insurance Law (GSSLA) defines an accident as the “sudden, unintentional damaging effect of unusual external factors on the human body, resulting in an impairment of physical, emotional or psychological health or death.” This is the case, for example, if someone on a bicycle is hit by a car, falls and breaks their arm.
Does the employer's obligation to continue to pay the salary or the insurer's obligation to pay benefits apply in every case?
No, any fault of the employee plays a role. The employer's obligation to continue to pay a salary pursuant to Article 324a of the Swiss Code of Obligations (OR) applies both in the case of accident and illness if the employee is unable to perform his work through no fault of his own. In the case of gross negligence, the salary entitlement may be reduced, and in the case of serious negligence, it may even be canceled.
The situation is similar with regard to entitlement to a daily allowance benefits under the mandatory accident insurance (LAI). If the accident was the result of a particularly risky behavior, a so-called risk, the insurance benefits can be reduced or even canceled in particularly severe cases.
For example, someone who has an accident on the slopes during a day's skiing and who suffers a broken bone, and is therefore absent from work for several weeks, is entitled to continued payment of salary or daily allowances.
On the other hand, anyone who takes a ski tour despite a high risk of avalanches, and has an accident in the process, risks having their benefits reduced or canceled because it is a risk.
What benefits does the mandatory accident insurance (LAI) cover ?
Which benefits are covered by the insurance, and to what amount, is defined by law. Accident insurance can provide care benefits and cost reimbursements as well as paying cash benefits (daily allowances, disability and survivors' pensions plus other kinds of indemnity).
What if the accident has long-term consequences for the health of the injured person?
Anyone who remains permanently disabled or disabled for a longer period of time due to an accident receives a disability pension. Anyone whose physical or mental integrity is damaged is entitled to an allowance for physical and mental impairment. Furthermore, anyone who is dependent on help from third parties receives a care allowance. If the consequences of the accident lead to the death of the person who suffered the accident, the surviving spouse and children are entitled to a survivors' pension or, if applicable, a settlement.
You can find further information in our compact LAI guidebook.
What happens in the case of events not covered by accident insurance?
Employees who are employed for less than an average of eight working hours per week are only insured against occupational accidents under mandatory accident insurance. If they have a non-occupational accident, the employer's obligation to continue to pay a salary pursuant to Article 324a of the Swiss Code of Obligations (OR) comes into play first of all. The employer is obliged to continue paying a salary during a "limited period". The Bern scale, the Zurich scale and the Basel scale are used to calculate the duration of the continued payment of salaries.
Does accident insurance also pay in the event of occupational illnesses?
Yes, an occupational illness is a special case of illness. As such, it does not meet the definition of an accident, but is still insured under the Swiss Federal Law on Accident Insurance (LAI). An occupational illness exists if it is "caused exclusively or predominantly by harmful substances or certain work in the course of the occupational activity". Furthermore, other illnesses that have been "proven to have been caused exclusively or predominantly by the occupational activity" also constitute occupational illnesses.
Mandatory accident insurance (LAI)
In Switzerland, all employees must be insured by their employer against the consequences of an accident under the LAI - the Federal Law on Accident Insurance. The insurance covers costs arising from occupational accidents (OA) and non-occupational accidents (NOA) as well as from an occupational illnesses. Those who work less than eight hours per week have no protection for non-occupational accidents. People who are not gainfully employed can cover their accident risk through the mandatory health insurance.
Read more about this in our compact guide.