Accident cover in your health insurance: include or exclude?

Two systems for the same protection: UVG and basic insurance

In Switzerland, accident protection runs through two systems: if you are employed by an employer for at least 8 hours a week, you are insured against accidents through your employer under the Accident Insurance Act (UVG). For everyone else, basic insurance (OKP) takes on this role: they include accident cover in their health insurance.

Accident cover is therefore a real choice when you take out basic insurance and, alongside place of residence, age, deductible and insurance model, one of the factors that determine the premium. You do not need the protection twice: if you are insured under the UVG, you can exclude accident cover from your OKP.

Exclude it and save: the 8-hour rule

What matters is your workload: from at least 8 hours a week with one employer, you have UVG protection, and accident cover in your basic insurance can be excluded, which lowers the premium.

The exclusion only concerns the accident risk: in the event of illness, your basic insurance remains unchanged with all its benefits. And if you switch insurer, compare with identical parameters (same deductible, same model, same accident cover), because only then can the premiums be compared.

When inclusion is necessary

Self-employed people and people not in employment need accident cover in their basic insurance, as they have no UVG protection through an employer. The same applies if you work less than 8 hours a week.

People not in employment include, for example, students without a side job, people doing family work or retired people. If you are unsure, check the agreed weekly workload in your employment contract; if in doubt, including it is the safe choice.

Changing or losing your job: the 31-day rule

When your employment ends, your employer's accident insurance continues for another 31 days. If you start a new job with at least 8 hours a week seamlessly or within this period, you remain insured under the UVG throughout, and accident cover can remain excluded from your health insurance.

If the gap lasts longer, there are two options, and two further points to keep in mind:

• Interim accident insurance (Abredeversicherung): your UVG cover can be extended by up to 6 months with your previous accident insurer.
• Inclusion in basic insurance: as soon as your UVG cover ends, accidents are automatically covered by your health insurer again (Art. 8 para. 2 KVG). Tell your insurer within one month of being informed by your employer or the unemployment insurance; otherwise it can claim the premium share with default interest (Art. 10 para. 2 KVG, Art. 11 para. 2 KVV).
• Unemployment: if you receive unemployment benefits (ALV daily allowances), you are insured against accidents through Suva.
• Keep an eye on premiums: your OKP premium continues unchanged if you lose your job; if your income is lower, it is worth looking at premium subsidies from your canton of residence.

How to notify your insurer of the change

You arrange the inclusion or exclusion of accident cover directly with your health insurer; you do not need to switch insurer to do so. As a rule, a short written notification is sufficient; depending on the insurer, this can also be done via the customer portal. For the exclusion, wording like this is enough:

“Dear Sir or Madam, since [date] I have been employed by [employer] with a workload of at least 8 hours a week and am therefore insured against accidents through my employer under the UVG. Please exclude accident cover from my basic insurance (policy no. [policy number]) as of the earliest possible date and send me an adjusted policy. Kind regards, [Name]”

After an employment ends, it works the other way round: your health insurer's accident cover resumes by itself when your UVG protection ends. Tell the insurer from when you no longer have UVG protection; this report is your duty, so that the premium is calculated correctly. Keep the adjusted policy as confirmation.

Conclusion: one simple rule, two stumbling blocks

The basic rule is simple: employed for at least 8 hours a week, exclude it and save; self-employed or not in employment, include it. Stumbling block number one is losing your job: interim accident insurance must be taken out before the 31 days of continued cover end; otherwise accident cover runs through your health insurer, and you must report it. Stumbling block number two is comparing with unequal parameters. In the easyall calculator, you enter accident cover for each person directly with the basic insurance details, so you automatically compare with the right parameters, and easy, our AI guide, answers detailed questions directly in the comparison.