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  #21  
Old 11.03.2018, 17:49
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Re: Sick leave payment while taking surgery abroad

Hey all,

In summary - so far this was just a short feedback provided by an HR assistant before leaving for the weekend, I couldn't have a longer conversation. I was a bit puzzled this was never mentioned before as well.

How would you suggest I approach the matter tomorrow with HR / Employer?

I guess as a first thing I will call up my law insurance.

Many thanks!
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Old 11.03.2018, 18:06
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Re: Sick leave payment while taking surgery abroad

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...How would you suggest I approach the matter tomorrow with HR / Employer?

I guess as a first thing I will call up my law insurance.
Try to approach it from a non-confrontational standpoint, if you can. This is something you feel entitled to, so it's logical you want to fight for it. You may get less push-back and hassle if you are trying to understand as opposed to fight (for now).

Your legal insurance may be able to clarify the whole in-country vs. abroad issue, and explain why it is that the insurance contract seems to take precedence.

I can understand the insurance having contract terms that say they won't pay the employer, but I don't understand how that translates to the employer not having to pay you at least the 80%.

Edit - screen shot of relevant paragraph of 324b with my own highlight below.
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File Type: jpg 324b.jpg (142.0 KB, 16 views)
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  #23  
Old 11.03.2018, 18:10
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Re: Sick leave payment while taking surgery abroad

Yes, I totally agree with 3Wishes. No guns a-blazing! Just asking nicely for HR to teach you [what they think is] the Swiss system. Thereafter you can go to your lawyer for advice, (assuming that isn't going to end up costing you more than it's worth), having gathered the relevant documents from HR.
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Old 11.03.2018, 18:35
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Re: Sick leave payment while taking surgery abroad

Big thank you all,

and I couldn't agree more - I won't go there "war mode" style. I do generally like my employer and therefore would like to keep things as pacific as possible.

I will call up my insurance just to have a legal understanding of the situation and soon after I will talk to HR / Employer accordingly.
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Old 11.03.2018, 18:47
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Re: Sick leave payment while taking surgery abroad

Also wanted to add - kudos to you for doing some research ahead of time.
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Old 11.03.2018, 18:57
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Re: Sick leave payment while taking surgery abroad

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Big thank you all,

and I couldn't agree more - I won't go there "war mode" style. I do generally like my employer and therefore would like to keep things as pacific as possible.

I will call up my insurance just to have a legal understanding of the situation and soon after I will talk to HR / Employer accordingly.
It would be great if you would post how it goes. I'm sure you will already have answers to the insurance situation next week. Wouldn't be surprised if you receive some info. from an informed EFer in between though.

All the best for the operation!
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Old 12.03.2018, 13:40
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Re: Sick leave payment while taking surgery abroad

Small intermediate update:

I called my law insurance to understand the situation and the below is their feedback:

While the insurance that firm has may decide to pay / not pay the sickness "Taggeld", the obligation to comply with Art.324 stays. I.e. as a minimum the firm will have to provide salary payments for the period indicated in the ZH Skala, in my case this would be 10 weeks.

This afternoon I will talk to HR, hopefully everything will be ok, last thing I want is to have a conflict honestly.

I'll keep you posted!
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Old 12.03.2018, 17:13
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Re: Sick leave payment while taking surgery abroad

Hi All,

Another update from my side - answer from HR assistant:

"Maybe your insurance covers this, they will send you a letter. If we they do not cover it, then we will discuss, maybe we cover it, we have to see".

I tried to be as calm as possible and just tried to clarify that this is something I'd need to know because they may appreciate there are significant costs behinf this.

Any recommendations on what to do next?

Thanks in advance
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  #29  
Old 12.03.2018, 19:09
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Re: Sick leave payment while taking surgery abroad

Suggestion:

"Dear HR Assistant,
Thank you for your phonecall/ conversation / meeting with Frau X / mail exchange of DATE and DATE. I am glad we have made a start at understanding the salary payments while I will be on sick-leave.

My doctors and I need to be sure that I have the insurance aspects clear before we go ahead with the treatment. They envisage that this will be in MONTHNAME, which means that everything needs to be lined up by at least DATE.

Therefore, would you please let me know:
1. When you write: "maybe your insurance covers this", do you mean INSURANCE COMPANY NAME through which EMPLOYERNAME has taken out the Taggeldversicherung?
2. Since you write: "they will send you a letter", do I understand correctly that you have already asked them?
3. By when do you anticipate that they will write to me?


As soon as I hear from INSURANCE COMPANY NAME I will contact you again.
Please let me know whether there is anything that you or I could do to expidite this matter.

Thank you for your help, which is much appreciated."
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  #30  
Old 12.03.2018, 20:14
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Re: Sick leave payment while taking surgery abroad

Perhaps irrelevant.

Why would you go to Germany and pay out of your own pocket if you need a new hip for medical reasons?

I am surprised to hear that the Swiss basic insurance would not cover this
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Old 12.03.2018, 21:16
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Re: Sick leave payment while taking surgery abroad

I suppose you do not wish to tell us which country, whether EU or not?

I wish you the very best of luck- but let's imagine that, for any reasons, things get complicated, either at the time or later. Who would pick up the bill for any further complications, linked issues, further treatment, etc? Would you expect Swiss insurers to pick up the tab? Or your employer to cover for more time off, support, etc.? Especially if the method used is new/experimental.
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  #32  
Old 12.03.2018, 23:36
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Re: Sick leave payment while taking surgery abroad

@Doropfiz, thank you! That's again a good approach to progress on this, I will probably need to know like tomorrow, cos the surgery is booked next week

In addition, I think tomorrow I will call my superior too. The thing is, that if I have to do it Switzerland, I'd have to start again the process of finding a surgeon I trust and book the operation again.

In my view, This'd be a lose-lose situation in my view as I am rolling off this week of my consulting project, so i wouldn't be staffed on another one, before doing this surgery. So I'd be more weeks "Unstaffed", making my firm losing even more revenue...

@Edwin / Odile - I am doing my first surgery in Italy (hip), and my second surgery in Germany (Sport Hernia), so both in EU. Multiple reasons attached to it, such as closeness to family for practical and moral support, method (not experimental, but rather superior as all football / NBA stars get treated there) and higher competence of the surgeons from the experiences I had (not intended to be a generalization of course).

I intend to pick up the bill for medical expenses in general.
What is also very vague and ambiguous about this insurance clause is that there is a specific mention about treatment AND care.
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Old 13.03.2018, 07:36
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Re: Sick leave payment while taking surgery abroad

moral of the story: if you want support from your insurance and your employer, clarify it in advance.

anyway, good luck and hope you'll have speedy recovery.
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Old 13.03.2018, 07:58
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Re: Sick leave payment while taking surgery abroad

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moral of the story: if you want support from your insurance and your employer, clarify it in advance.

anyway, good luck and hope you'll have speedy recovery.
Hi K_and_e,

Thank you and also hope to recover asap.

I am not sure this applies as I had informed my employer and HR more than a month ago.

My employer probably doesn't even know there is this clause in the insurance, HR just came up with this last Friday....
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Old 13.03.2018, 12:29
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Re: Sick leave payment while taking surgery abroad

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I am surprised to hear that the Swiss basic insurance would not cover this
It probably does, but only in Switzerland.

IIRC medical treatments outside of the country are paid if a) emergency or an acute case while you're abroad or b) treatment or sufficient alternative not available in Switzerland. Everything else performed abroad (including drugs bought abroad) is excluded. You won't get financed what someone considers to be best, but effetive and (cost-)efficient treatment.
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Old 13.03.2018, 13:54
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Re: Sick leave payment while taking surgery abroad

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It probably does, but only in Switzerland.

IIRC medical treatments outside of the country are paid if a) emergency or an acute case while you're abroad or b) treatment or sufficient alternative not available in Switzerland. Everything else performed abroad (including drugs bought abroad) is excluded. You won't get financed what someone considers to be best, but effetive and (cost-)efficient treatment.
Hi Urs Max, indeed i think it is what you mentioned, except the cost-effiecient part or at least, not cost-efficient for me Potentially the insurance could save if they ever decided to cover, but it's difficult to quantify their savings because they have processes in place with the swiss authorities, making it very efficient.

Anyway, as mentioned I am not really expecting that my health insurance covers this, it would be a nice plus. Rather, I am hoping my employer / insurance of my employeers provides me with the salary payment.
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Old 13.03.2018, 17:49
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Re: Sick leave payment while taking surgery abroad

All,

An update on this:

Finally, after urging HR to double-check, I was told that should the sickness loss of earning insurance not cover, I would be given only the bare minimum indicated by the law, which, in my case, would amount to 10 weeks of salary.

I am satisfied that at least the law is being respected. However I am not of course thrilled that this is being done. But these are personal considerations and probably irrelavant for this thread

Moral -
1. Better have a law insurance to check these things
2. Ensure HR have checked their sources before providing you with an answer
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  #38  
Old 13.03.2018, 19:29
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Re: Sick leave payment while taking surgery abroad

Those 10 weeks should cover your time abroad, shouldn't they? Then once you are back in Switzerland, a Swiss doctor can sign you off again if needed and the usual sick leave payment rules with the insurance company apply.
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Old 14.03.2018, 08:28
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Re: Sick leave payment while taking surgery abroad

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Then once you are back in Switzerland, a Swiss doctor can sign you off again if needed and the usual sick leave payment rules with the insurance company apply.
I wouldn't count on that without prior confirmation. This may be seen as a follow-on, not a new incident, that is covered by ordinary insurance law rather than KVG (health insurance law), and the company apparently takes the position that they've alredy done their due. This may become particularly relevant in case of complications (you never know) that requires more than 10 weeks leave.
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Old 14.03.2018, 09:19
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Re: Sick leave payment while taking surgery abroad

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I wouldn't count on that without prior confirmation. This may be seen as a follow-on, not a new incident, that is covered by ordinary insurance law rather than KVG (health insurance law), and the company apparently takes the position that they've alredy done their due. This may become particularly relevant in case of complications (you never know) that requires more than 10 weeks leave.
Good point. Didn't think about that. As if surgery itself wasn't stressful enough, then one has to deal with the employer and insurance complexities.
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