Accident Insurance (AIA) in Switzerland: Coverage and Benefits

Compulsory Accident Insurance in Switzerland (AIA)

The Federal Act on Accident Insurance (AIA/LAA) establishes a compulsory insurance scheme covering employed workers against the economic consequences of accidents and occupational diseases. This system constitutes an essential pillar of Swiss social security.

Compulsory Insurance (Art. 1a AIA)

Under art. 1a AIA, all workers employed in Switzerland are compulsorily insured against accidents. The insurance obligation arises from the first day of work, including during the probationary period. The employer is required to take out the insurance and bear the premiums for occupational accidents.

Workers employed for at least eight hours per week with the same employer are also insured against non-occupational accidents (art. 7 para. 1 AIA). Those who work less than eight hours are only covered for occupational accidents and accidents occurring on the journey between home and the workplace.

Occupational and Non-Occupational Accidents (Art. 6-8 AIA)

Art. 6 AIA defines the scope of application: the insurance covers occupational accidents, non-occupational accidents and occupational diseases. Art. 7 AIA specifies that non-occupational accidents include all accidents that are not occupational, including leisure and sports accidents.

Occupational diseases (art. 9 AIA) are those caused exclusively or predominantly by the exercise of the professional activity. A list of harmful substances and recognised diseases is set out in the Accident Insurance Ordinance (AIO).

Daily Allowance (Art. 15-17 AIA)

The daily allowance is paid from the third day following the accident (art. 16 para. 2 AIA). It amounts to 80% of the insured earnings (art. 17 para. 1 AIA), with a maximum insured earnings currently set at CHF 148,200 per year.

Key points:

1. The employer pays the salary for the day of the accident and the following two days (art. 324a CO)
2. The allowance is paid until full recovery, the granting of a disability pension or the death of the insured
3. The allowance is not subject to OASI/DI/ALI contributions

Disability Pension (Art. 18-20 AIA)

If the accident results in permanent disability, the insured is entitled to a disability pension (art. 18 AIA). The pension amounts to 80% of the insured earnings multiplied by the degree of disability. For example, 50% disability gives entitlement to a pension of 40% of the insured earnings.

Art. 19 AIA specifies that the right to a pension arises when no significant improvement in the state of health can be expected from continued medical treatment. In cases of partial disability, the integrity allowance (art. 24-25 AIA) may be added to the pension.

Survivor Benefits (Art. 28-33 AIA)

In case of death of the insured as a result of the accident, survivors are entitled to pensions:

1. Widow/widower pension: 40% of insured earnings (art. 29 AIA)
2. Orphan pension: 15% of insured earnings per child (art. 30 AIA)
3. Total pensions may not exceed 70% of insured earnings (art. 31 AIA)
4. A funeral expenses allowance is also paid (art. 28 AIA)

Financing

Premiums for occupational accident insurance are borne entirely by the employer. Premiums for non-occupational accident insurance are in principle borne by the worker, although many collective bargaining agreements provide for partial or full coverage by the employer.