Accident Insurance (Unfallversicherung)
Accident insurance pays a benefit when a sudden, externally acting event causes involuntary bodily injury to the insured person, regardless of where the event occurs.
Comparison profile
- Trigger
- Fixed sum insured
- Insured interest
- The physical and mental integrity and earning capacity of the insured person against the consequences of accidental bodily injury, irrespective of where or during which activity it occurs.
- Rating basis
- Occupation and occupational risk class, Age of the insured person, Scope selected (occupational-only vs. 24-hour worldwide cover), Sum insured chosen for death and disability benefits, Hazardous-sports extensions
- Typical limits
- Disability capital is typically agreed in the range of CHF/EUR 100,000 to several million, with progression tables that can pay out several times the base sum at high degrees of disability; an annuity option is common for severe cases.
- Target segments
- Private, SME, Industry
Insured events
- Accidental death of the insured person
- Permanent disability, partial or total, following an accident
- Temporary incapacity to work (daily accident allowance)
- Hospitalisation following an accident
- Medical treatment and rescue costs following an accident
Key exclusions
- Illness not triggered by an accident
- Intentional self-harm and suicide attempts
- War and civil unrest (unless expressly bought back)
- Certain hazardous activities (Wagnisse), which are excluded or subject to a benefit reduction
- Infections not caused by an accidental wound
Concept
Accident insurance pays a benefit where the insured person suffers involuntary bodily injury as a result of a sudden, externally acting event (an accident). Unlike health insurance, which covers all illnesses regardless of their cause, accident insurance’s obligation to pay is limited to the narrower definition of an accident; unlike statutory accident insurance, private accident insurance applies regardless of whether the accident occurs during working hours, leisure time, or at home.
Types of Benefits
Key benefit types include the disability benefit, paid either as a one-time lump sum or as an accident annuity depending on the degree of disability; the death benefit in the event of accidental death of the insured person; the daily accident allowance to compensate for temporary incapacity to work; and the hospital daily allowance for the duration of an inpatient stay following an accident.
Determining the Disability Benefit
The disability benefit is generally determined using a contractually agreed schedule of benefits (a “limb scale”), which sets fixed degrees of disability for the loss or complete loss of function of specific body parts or sensory organs; where multiple body parts are affected, or where an impairment is not covered by the schedule, the classification is based on the degree of impairment of overall physical or mental capacity.
Comparison and delineation
Private accident insurance is the individually underwritten counterpart to group personal accident insurance, which a company or association takes out for a defined group of persons; both provide broadly the same benefit types and are largely interchangeable, so employers typically choose one distribution route rather than layering both for the same person. It is regularly complemented by passenger accident insurance, which adds vehicle-specific occupant cover, by child disability insurance, which extends the disability trigger to illness for children, and by supplementary UVG cover, which tops up the statutory Swiss accident insurance scheme with capital benefits and salary components it does not provide.