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Accidents

  • What must I do in the event of an accident?

    You must notify the accident immediately to the personnel service of your employer which will in turn notify Groupe Mutuel. Early reporting will avoid the need for service providers to send invoices to your home address.

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  • Does the accident insurance plan pay for alternative medicine treatments?

    No, but you should check whether you benefit from supplemental private insurance (as part of your health insurance or supplemental LAA/UVG insurance) which does cover such costs.

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  • Does the accident insurance plan pay the cost of a home help?

    Unlike care provided at home, accident insurance does not reimburse costs of this kind. You should check whether you benefit from a supplemental private insurance (as part of your health insurance or supplemental LAA/UVG insurance) which does provide such coverage.

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  • Can I change my doctor while treatment is in progress?

    Yes, but you must notify this change to the insurer.

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  • How am I covered in the event of an accident abroad?

    LAA/UVG covers the cost of services in a maximum amount of twice the costs which would have been incurred in Switzerland. If you travel to a member state of the European Union take the European health insurance card with you. Your health insurer will be happy to issue this card.

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  • Do I have to pay my invoices before sending them to you?

    Unlike health insurance (LAMal/KVG), LAA/UVG insurance does make provision for the  third party payment system. The insurer and not the patient must pay for the service provided. When the treatment begins, you must always notify the name of your insurer and the accident number, if you know this, to the care providers used by you. By doing so, you will not receive any bills yourself.  

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  • Must I pay a contribution (deductible sum and 10% share)?

    No, medical costs are fully paid by the accident insurer (hospital care in public ward).

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  • What must I do before being admitted to hospital?

    Except for emergency cases, the hospital will ask your insurer for a guarantee.
    Please therefore contact us before any admission to a hospital establishment to avoid unpleasant surprises if your insurance coverage for illness is not identical.

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  • I have suffered a dental accident. Can I authorise my dentist to give the necessary treatment?

    No, except for emergency treatment the agreement signed between dentists and the LAA/UVG insurers stipulates that the LAA/UVG insurer will only pay for treatments for which he has given his prior consent.

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  • When I am insured by my employer, do I have to pay the LAA/UVG non-occupational accident premium?

    Yes, unless otherwise stipulated in your employment contract, the employer is only responsible for paying the premium against occupational accidents.

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  • What sports are insured only in part or not at all?

    A person who reasonably engages in a sport can expect to be fully covered by LAA/UVG. However, some activities are regarded as hazardous ventures and the cash benefits are cut by 50% in accordance with Art. 39 of the Federal Law on Accident Insurance (LAA/UVG).

    Here is a non-exhaustive list of these activities which require a supplemental insurance to be taken out within the framework of the association to which the sportsperson belongs:

    • hazardous ventures with a motor vehicle (auto-cross, stock car races, race track events, hill climbing races and training; speed trials during rallies);
    • boxing matches;
    • wrestling;
    • full-contact combat;
    • extreme karate (breaking bricks, tiles or thick planks with the side of the hand, the foot or the head);
    • moto cross races including race track training;
    • power boat races including training;
    • motor cycle races including training;
    • downhill mountain bike or city cycle races, including training on the race track;
    • ski speed record attempts;
    • scuba diving to depths of more than 40 m;
    • hydro-speed or river boogie (going down white water courses lying flat on a nautical bob);
    • snow rafting (races in pneumatic boats on ski runs).

    If in doubt please contact us.

     

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  • Am I covered in the event of unpaid leave or cessation of activity?

    If you work for not less than 8 hours a week for an employer, you benefit from non-occupational accident insurance for a further 30 days after the end of the entitlement to at least a half-salary. This insurance can be extended for a further 180 days by taking out an agreed insurance which will cost you CHF 25.- per month or part thereof.  

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  • If I am insured by my employer, must I retain accident coverage under my health insurance plan?

    You may delete the accident risk from the LAMal/KVG compulsory health insurance if you work for at least 8 hours a week for an employer. On the other hand it is useful to maintain your accident risk coverage under your supplemental LCA health insurance plan.

    If you are insured by a Groupe Mutuel insurer, this coverage may be suspended from your compulsory health insurance for the month following your application.

    Please send us your request for suspension online.

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  • Can I travel abroad during medical treatment?

    You are kindly requested to notify the insurer beforehand. That said, if there is no medical contra-indication and such travel does not delay the cure, it is perfectly possible to accept your request. The situation is more complex if treatment is required during your stay abroad.

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  • How is the daily allowance calculated?

    The daily allowance corresponds to 80% of the loss of earnings paid from the 3rd day following the accident. It takes account of the 13th month’s salary and possible family allowances. The annual salary arrived at is divided by 365 and covered at the rate of 80%.

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  • Are transport costs refunded?

    Yes, by the most economical means of transport and to the nearest doctor. If the use of a vehicle is necessary, a km rate is allowed at CHF 0.60 per km. Under certain conditions, transport may also be refunded with the prior agreement of the insurer if it enables the person concerned to return to work much sooner.

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  • Can the accident risk be deleted from supplemental insurance policies?

    The accident risk is included in supplemental insurance policies with no extra premium. It therefore cannot be deleted.

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  • Must accident coverage be adjusted during a period without gainful activity or upon retirement?

    Yes. Accident coverage must be included in your compulsory health insurance because your employer no longer provides you with insurance against this risk.

    Compulsory accident insurance coverage in fact lapses at the end of the thirtieth day following the day on which the entitlement to at least a half-salary ended.

    Send us your request online.

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  • What about accident coverage during a period of unemployment?

    Persons who benefit from unemployment allowances must always be insured against accident by the SUVA unemployment plan.

    To suspend accident coverage from compulsory health insurance, please send a written request to us, together with the account statement from your unemployment benefits plan.

     

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