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-   -   Wife's employer didn't take out accident insurance (I think) (https://www.englishforum.ch/insurance/107874-wife-s-employer-didn-t-take-out-accident-insurance-i-think.html)

Cosmos 03.03.2011 10:34

Wife's employer didn't take out accident insurance (I think)
 
And now my wife has had an accident.

I won't go into the gory details of it all. But my wife had an accident while we were visiting back in home in the UK. I delayed her flight for coming back. Since the accident involves burns I would like her bandages to be changed and for her burns to be checked for infections etc. when she comes back to Switzerland.

She works more than 8 hours per week as a nanny with a contract in Switzerland. The contract states the employer will provide accident insurance for her. When emailed about the details for this insurance the employer gave a very sketchy reply with strong suggestions that she should recover in the UK. When prompted further, no reply was received.

The NHS is underfunded enough without non-residents leeching off it IMO.

What would everyone suggest I do to move forward with this? I'm thinking to suggest that if she hasn't taken accident insurance then she can pay for any medical bills my wife has in Switzerland.

If they suddenly decide to be awkward about it then what? She has a legal obligation to insure her employees against accidents.

Thanks in advance for your help.


I live in the French speaking part of Switzerland.

03.03.2011 10:48

Re: Wife's employer didn't take out accident insurance (I think)
 
Quote:

Originally Posted by Cosmos (Post 1123120)
And now my wife has had an accident.

I won't go into the gory details of it all. But my wife had an accident while we were visiting back in home in the UK. I delayed her flight for coming back. Since the accident involves burns I would like her bandages to be changed and for her burns to be checked for infections etc. when she comes back to Switzerland.

She works more than 8 hours per week as a nanny with a contract in Switzerland. The contract states the employer will provide accident insurance for her. When emailed about the details for this insurance the employer gave a very sketchy reply with strong suggestions that she should recover in the UK. When prompted further, no reply was received.

The NHS is underfunded enough without non-residents leeching off it IMO.

What would everyone suggest I do to move forward with this? I'm thinking to suggest that if she hasn't taken accident insurance then she can pay for any medical bills my wife has in Switzerland.

If they suddenly decide to be awkward about it then what? She has a legal obligation to insure her employees against accidents.

Thanks in advance for your help.


I live in the French speaking part of Switzerland.

Accident insurance or medical insurance? AFAIK, accident insurance is insurance for employee accidents sustained at work. Medical insurance is normally the obligation of the individual not the employer and is mandatory in Switzerland.

Cosmos 03.03.2011 10:59

Re: Wife's employer didn't take out accident insurance (I think)
 
Quote:

Originally Posted by economisto (Post 1123138)
Accident insurance or medical insurance? AFAIK, accident insurance is insurance for employee accidents sustained at work. Medical insurance is normally the obligation of the individual not the employer and is mandatory in Switzerland.

Thanks for your reply.

http://www.admin.ch/ch/f/rs/832_202/a13.html

Quote:

A part-time workers employed by an employer at least eight hours per week are also insured against non-occupational accidents. 1

Mikers 03.03.2011 11:15

Re: Wife's employer didn't take out accident insurance (I think)
 
Quote:

Originally Posted by economisto (Post 1123138)
Accident insurance or medical insurance? AFAIK, accident insurance is insurance for employee accidents sustained at work. Medical insurance is normally the obligation of the individual not the employer and is mandatory in Switzerland.

Hi Economisto, I humbly think this isnt actually the case - accident by the employer is to cover all accidents you have whether in or out of work. in my time here the employers accident cover also covered a skiing accident and a football injury I have had for example.

Corbets 03.03.2011 11:45

Re: Wife's employer didn't take out accident insurance (I think)
 
I would simply contact the employer again and state that you need the details of her accident coverage as these bills need to be paid. If she doesn't respond with details, or if she states that there is no coverage, suggest that she pay for the bills. If that fails, let her know that you'll be going to the authorities to discuss this.

I don't know that you'll get any kind of benefit from the authorities (i.e. I don't know if they'll give you some kind of financial compensation from your employer) but they'll definitely give her some grief.

03.03.2011 12:37

Re: Wife's employer didn't take out accident insurance (I think)
 
Well it would be simpler if she recovered in the UK. Otherwise you can continue treatment here but you will have to fight for the return of the doctor's fees.

Many foreigners are entitled to free care on the British NHS, I expect they have already asked to see your wife's passport.

In the meantime you need to ask here where to start accusing the employer of breaking Swiss laws. I would first ask at your Commune, maybe the social services department. Would you like to name and shame the employer here? Maybe your health insurance agent can also help you.

Upthehatters2008 03.03.2011 12:47

Re: Wife's employer didn't take out accident insurance (I think)
 
Quote:

Originally Posted by Ittigen (Post 1123318)
Well it would be simpler if she recovered in the UK. Otherwise you can continue treatment here but you will have to fight for the return of the doctor's fees.

Many foreigners are entitled to free care on the British NHS, I expect they have already asked to see your wife's passport.

In the meantime you need to ask here where to start accusing the employer of breaking Swiss laws. I would first ask at your Commune, maybe the social services department. Would you like to name and shame the employer here? Maybe your health insurance agent can also help you.



Easy Tiger... There is no proof that the Employer does not have insurance. Merely that the Employer has not provided the insurance details.

Guest 03.03.2011 12:47

Re: Wife's employer didn't take out accident insurance (I think)
 
It's a difficult situation for you, so I hope your wife will recover soon.
I am however a bit confused- if you are resident here, you have to have medical Insurance yourself by law, which would cover her anyway. Are you not covered by holiday insurance either?

Mud 03.03.2011 12:50

Re: Wife's employer didn't take out accident insurance (I think)
 
Quote:

It's a difficult situation for you, so I hope your wife will recover soon.
I am however a bit confused- if you are resident here, you have to have medical Insurance yourself by law, which would cover her anyway. Are you not covered by holiday insurance either?
Not so sure about that- in instances where I had an accident the doc was very keen to have the accident insurance and couldn't be bothered with my health insurance.

As it's the employer's responsibility to provide accident coverage, if they haven't (still to be seen), then I imagine it would be like if you didn't have health insurance and had to seek care for something covered by that- that is, they will have to pay out of pocket.

PaddyG 03.03.2011 12:51

Re: Wife's employer didn't take out accident insurance (I think)
 
Quote:

It's a difficult situation for you, so I hope your wife will recover soon.
I am however a bit confused- if you are resident here, you have to have medical Insurance yourself by law, which would cover her anyway. Are you not covered by holiday insurance either?
That all depends if the a) the OP and his wife have joint medical coverage (not everone does, me for example) b)the medical insurance includes accident insurance (not all do, mine for example :), my employer covers that, even non-work related accidents)

foliorose 03.03.2011 12:52

Re: Wife's employer didn't take out accident insurance (I think)
 
Cosmos, I am so sorry you and your wife have to deal with this stress on top of her injuries! :( It's frustrating that your wife is working with a contract and following all the rules and then this happens anyway!

I agree with Ittigen. If your wife can stay in the UK for a while it might make things simpler until you can figure out where you stand and who's responsible to pay here. If you're feeling guilty about using the NHS that's understandable, but if you paid in for many years and need it now, you are still citizens and it's still your country.

I wish you lots of luck!

Cosmos 03.03.2011 13:04

Re: Wife's employer didn't take out accident insurance (I think)
 
Quote:

Originally Posted by Corbets (Post 1123218)
I would simply contact the employer again and state that you need the details of her accident coverage as these bills need to be paid. If she doesn't respond with details, or if she states that there is no coverage, suggest that she pay for the bills. If that fails, let her know that you'll be going to the authorities to discuss this.

I don't know that you'll get any kind of benefit from the authorities (i.e. I don't know if they'll give you some kind of financial compensation from your employer) but they'll definitely give her some grief.

Thanks for this post. I can't thank yet so you have to accept thanks like this.

When you say authorities. Should I just go to the controle des habitants? Which authorities? :confused:

Quote:

Originally Posted by Ittigen (Post 1123318)
Well it would be simpler if she recovered in the UK. Otherwise you can continue treatment here but you will have to fight for the return of the doctor's fees.

Many foreigners are entitled to free care on the British NHS, I expect they have already asked to see your wife's passport.

In the meantime you need to ask here where to start accusing the employer of breaking Swiss laws. I would first ask at your Commune, maybe the social services department. Would you like to name and shame the employer here? Maybe your health insurance agent can also help you.

I will wait to confirm that she isn't covered. But if she was I'd imagine I'd have a reply by now. This thread is basically trying to get as much information as possible for that eventuality. Hopefully this thread was a waste of time and she is covered and we all live happily ever after :)



Quote:

Originally Posted by PaddyG (Post 1123338)
That all depends if the a) the OP and his wife have joint medical coverage (not everone does, me for example) b)the medical insurance includes accident insurance (not all do, mine for example :), my employer covers that, even non-work related accidents)

Well she does have accident insurance which I paid for from before she got her job which I haven't cancelled. But it has a 2500CHF franchise. I understand that employer provided accident insurance has no franchise.

Quote:

Originally Posted by foliorose (Post 1123342)
Cosmos, I am so sorry you and your wife have to deal with this stress on top of her injuries! :( It's frustrating that your wife is working with a contract and following all the rules and then this happens anyway!

I agree with Ittigen. If your wife can stay in the UK for a while it might make things simpler until you can figure out where you stand and who's responsible to pay here. If you're feeling guilty about using the NHS that's understandable, but if you paid in for many years and need it now, you are still citizens and it's still your country.

I wish you lots of luck!

Thank you. It's not as if she is admitted to hospital. She is at home. But she is all bandaged up and would need them changed once a week I'd imagine...and then checked for infection....and pain killers. The costs add up and should be covered by the employer provided accident insurance!

Thanks to all for your replies.

Snoopy 03.03.2011 13:17

Re: Wife's employer didn't take out accident insurance (I think)
 
http://familienforum.liliput.ch/Download/Obligatorische_Unfallversicherung_6.05-D.pdf

Employers must take out accident insurance for their employees, see link. If you have doubts talk to the AHV people. Question is whether the employer has been paying social security? If not they are in even bigger trouble...

Guest 03.03.2011 13:20

Re: Wife's employer didn't take out accident insurance (I think)
 
If you need help with language issues, will be happy to help.

Cosmos 03.03.2011 13:27

Re: Wife's employer didn't take out accident insurance (I think)
 
Quote:

Originally Posted by Snoopy (Post 1123369)
http://familienforum.liliput.ch/Download/Obligatorische_Unfallversicherung_6.05-D.pdf

Employers must take out accident insurance for their employees, see link. If you have doubts talk to the AHV people. Question is whether the employer has been paying social security? If not they are in even bigger trouble...

My wife was recently given her AVS card (AVS and AHV are the same right?)...so I am confident that she has been paying social security. This is why I'm so surprised about them being so reluctant about the accident insurance.

Her employer is a very above board person with the contract and everything so it may well have been something that slipped her mind....but that's really not good enough. My wife just does this to keep her busy and gets paid terribly. The least her employer could do is her legal obligations.

Snoopy 03.03.2011 14:14

Re: Wife's employer didn't take out accident insurance (I think)
 
Quote:

Originally Posted by Cosmos (Post 1123384)
My wife was recently given her AVS card (AVS and AHV are the same right?)...so I am confident that she has been paying social security. This is why I'm so surprised about them being so reluctant about the accident.

Particularly as it would only be about 10-15 chf a month...

Lou 03.03.2011 14:16

Re: Wife's employer didn't take out accident insurance (I think)
 
Is accident insurance pro rated (sp?) for a part time employee?

Quote:

Originally Posted by Snoopy (Post 1123465)
Particularly as it would only be about 10-15 chf a month...


Cosmos 03.03.2011 14:23

Re: Wife's employer didn't take out accident insurance (I think)
 
Would the employer have to pay the franchise for the accident insurance or is there just none?

Guest 03.03.2011 14:25

Re: Wife's employer didn't take out accident insurance (I think)
 
There is none for employee insurance.

Lou 03.03.2011 14:40

Re: Wife's employer didn't take out accident insurance (I think)
 
Odile is correct, when my nanny claimed on the accident insurance I provided for her they company paid 100% of the claim.

Quote:

Originally Posted by Cosmos (Post 1123489)
Would the employer have to pay the franchise for the accident insurance or is there just none?


Cosmos 03.03.2011 14:43

Re: Wife's employer didn't take out accident insurance (I think)
 
I don't have a thanks button but thanks to all that are replying :)

Oldhand 03.03.2011 15:42

Re: Wife's employer didn't take out accident insurance (I think)
 
You could write to the employer again and state that if you don't receive insurance details within 24 hours, you'll have no alternative to contact your own insurance and hold her liable for the franchise.

May at least get you a reply.

Guest 03.03.2011 15:55

Re: Wife's employer didn't take out accident insurance (I think)
 
Your insurance may well then sue them for all costs, not just franchise, if they realise she should have been insured by employer.

Cosmos 03.03.2011 15:59

Re: Wife's employer didn't take out accident insurance (I think)
 
I received an email reply. Needless to say I'm not impressed with the tone of the reply. If anyone wants specifics about details then please PM me and I will relay them.

But as it stands it looks like she's saying that the employer should pass the details of the accident onto the insurance etc. or she wants the invoices so she can pay them herself.

Am I entitled to know which insurance company my Wife is insured with and for her to have an accident insurance card as well? Or is this tied into her health insurance card.

Lou 03.03.2011 16:38

Re: Wife's employer didn't take out accident insurance (I think)
 
Speaking only as someone who has an employee & how I think it works. It can be either the employee or employer who informs the accident insurance company, I don't think that it matteres who. However your wife is entitled to know who she is insured by in case she needs to claim & her employer is not available. There may be no card, I did not receive one for my employee but she can have all the details of the policy.

It could be that the employer genuinley forgot to arrange the insurance even though she legally should have. Have you tried just asking nicely if this is the case? How long has your wife been employed by this person?


Quote:

Originally Posted by Cosmos (Post 1123644)
I received an email reply. Needless to say I'm not impressed with the tone of the reply. If anyone wants specifics about details then please PM me and I will relay them.

But as it stands it looks like she's saying that the employer should pass the details of the accident onto the insurance etc. or she wants the invoices so she can pay them herself.

Am I entitled to know which insurance company my Wife is insured with and for her to have an accident insurance card as well? Or is this tied into her health insurance card.


Cosmos 03.03.2011 17:40

Re: Wife's employer didn't take out accident insurance (I think)
 
Quote:

Originally Posted by Lou (Post 1123717)
Speaking only as someone who has an employee & how I think it works. It can be either the employee or employer who informs the accident insurance company, I don't think that it matteres who. However your wife is entitled to know who she is insured by in case she needs to claim & her employer is not available. There may be no card, I did not receive one for my employee but she can have all the details of the policy.

It could be that the employer genuinley forgot to arrange the insurance even though she legally should have. Have you tried just asking nicely if this is the case? How long has your wife been employed by this person?

She's been employed for about 2 months in total with a break between the months over the festive period.

Snoopy 03.03.2011 17:44

Re: Wife's employer didn't take out accident insurance (I think)
 
Quote:

Originally Posted by Lou (Post 1123717)
It could be that the employer genuinley forgot to arrange the insurance even though she legally should have. Have you tried just asking nicely if this is the case?

I think this would be an excellent first step....

Ziger 03.03.2011 18:08

Re: Wife's employer didn't take out accident insurance (I think)
 
Quote:

Originally Posted by Lou (Post 1123717)
It could be that the employer genuinley forgot to arrange the insurance even though she legally should have. Have you tried just asking nicely if this is the case?

Yes, I agree with Snoopy and Lou that clarifying the exact situation is the first step. If, however, you do not get clear answers, here is an organisation that will help, even in English: http://www.versicherungsombudsman.ch/html/guide_e.html.

Guest 03.03.2011 18:14

Re: Wife's employer didn't take out accident insurance (I think)
 
It's essential to find out what the exact situation is with the employer, as you will have to give insurance detail when you go to the Polyclinic/burns unit for your first appointment. You need to go at least 30 mins in advance of appointment to register properly at reception (including giving details of Insurance). Not sure how good your French is, but if necessary, take a friend/colleague who can interpret if necessary. Will come if necessary, but I live quite a way away. Regards.

Ziger 03.03.2011 18:19

Re: Wife's employer didn't take out accident insurance (I think)
 
I forgot to give you this link which explains in English who (and what) is covered under the compulsory accident insurance: http://www.bag.admin.ch/themen/versicherung/00321/00335/index.html?lang=en.

And: Gute Besserung to your wife!

swisspea 03.03.2011 18:36

Re: Wife's employer didn't take out accident insurance (I think)
 
Have you also checked your wife's medical insurance ?

I am currently trying to extract myself from paying double 'accident' insurance because at first I was not working, so had to have accident insurance with my personal health insurance, then I started working, and didn't realise that now my employer would be paying the accident insurance....
18 months later I still haven't got around to getting the right paperwork from my employer to prove that I am covered - my illness insurer won't cancel the accident part until they have documents...

Mica 03.03.2011 18:47

Re: Wife's employer didn't take out accident insurance (I think)
 
In case an employer has "forgotten" to insure his employees, there is a special "Ersatzkasse UVG" which will pay the expenditure for accidents, and then assess the employer the dues he or she should have paid.
http://www.ersatzkasse.ch/de/taetigkeitsbereich/
cf. also Art. 73 UVG

Contact:

Leistungsfälle
Jean-Jacques Hagen
Direktwahl: 058 358 05 73
E-Mail: jean-jacques.hagen@who-needs-spam.ersatzkasse.ch (without the who----).

Or if you are in Zurich you might want to contact the SVA Zürich
http://www.svazurich.ch

But you might want to take it up with her employer first, so that they can come clean with the authorities first :-)

fatmanfilms 03.03.2011 19:56

Re: Wife's employer didn't take out accident insurance (I think)
 
Quote:

Originally Posted by Oldhand (Post 1123605)
You could write to the employer again and state that if you don't receive insurance details within 24 hours, you'll have no alternative to contact your own insurance and hold her liable for the franchise.

May at least get you a reply.

The other insurance is for sickness not accident so it wont pay/

Non work accident insurance is usually paid by splitting the cost 50/50 employee/employer, was any deduction made from salary?

Guest 03.03.2011 20:12

Re: Wife's employer didn't take out accident insurance (I think)
 
I'd tell them that the hospital have told you that you will need to give Insurance details at her first appointment, and INSIST that they give you those details- or that you will have no option but to go the legal route. Ask them directly, if not forthcoming, whether Insurance was or was NOT taken - show them the links above and the relevant part of the contract - and ask them, if the answer is NO, how they intend to proceed - and guarantees that medical costs WILL be paid. Am I right in thinking that they will have to continue to pay her until she is fit to work again? she might be able to return to work soon if no babies or toddlers are involved (eg no lifiting/carrying). (from the top of my head here - I am NO Insurance expert- but the links given seem clear enough). Must say though that I would personally prefer to handle this face to face than by e-mail - is that possible?

Cosmos 03.03.2011 20:35

Re: Wife's employer didn't take out accident insurance (I think)
 
I think that is the best idea. A simple situation is being made very complicated here :(

Cosmos 03.03.2011 20:35

Re: Wife's employer didn't take out accident insurance (I think)
 
Quote:

Originally Posted by Mica (Post 1123912)
In case an employer has "forgotten" to insure his employees, there is a special "Ersatzkasse UVG" which will pay the expenditure for accidents, and then assess the employer the dues he or she should have paid.
http://www.ersatzkasse.ch/de/taetigkeitsbereich/
cf. also Art. 73 UVG

Contact:

Leistungsfälle
Jean-Jacques Hagen
Direktwahl: 058 358 05 73
E-Mail: jean-jacques.hagen@who-needs-spam.ersatzkasse.ch (without the who----).

Or if you are in Zurich you might want to contact the SVA Zürich
http://www.svazurich.ch

But you might want to take it up with her employer first, so that they can come clean with the authorities first :-)


Excellent post. Thanks so much. A lot of it doesn't make sense with google translate but I think I get the gist of it :)

Cosmos 03.03.2011 20:39

Re: Wife's employer didn't take out accident insurance (I think)
 
Quote:

Originally Posted by swisspea (Post 1123901)
Have you also checked your wife's medical insurance ?

I am currently trying to extract myself from paying double 'accident' insurance because at first I was not working, so had to have accident insurance with my personal health insurance, then I started working, and didn't realise that now my employer would be paying the accident insurance....
18 months later I still haven't got around to getting the right paperwork from my employer to prove that I am covered - my illness insurer won't cancel the accident part until they have documents...

She does still have accident insurance which I pay for her. However there is a 2500CHF franchise with this...as apposed to the employer provided one which has no franchise.

yjt 03.03.2011 20:53

Re: Wife's employer didn't take out accident insurance (I think)
 
Well I've had a couple of free time accidents. I've never had to directly deal with the insurance company. The first time I even forgot which company it was but the hospital must have sorted it out with them. When I was back at work I was had to give some details through to the HR people about what has happened and that was it.

So in short I've never had an accident insurance card and it's not unusual that the company deals with the insurance. What is strange though is why they don't want to tell you the name of it. Do you have the contract or pay slip? It should say on them how much gets taken of for it

swisspea 03.03.2011 21:52

Re: Wife's employer didn't take out accident insurance (I think)
 
My husband had an accident - got hit by a car on a pedestrian crossing :eek:

He didn't actually get any medical care, but his employer as soon as they knew of the accident, reported it to the insurance company, and the insurance company contacted my husband three times to get all the details, inform him of the procedures (they actually did a police report on his behalf!), and follow up to make sure that there were no further consequences.

So, in some ways, yes, the employer is correct, the employee needs to supply the basic details of the accident, where you went, and what was done, so that the process can be started with the insurance company...

Our health insurance definitely covers accidents/sickness outside Switzerland, with some limitations...

It does sound like everyone's panicking, but there's a system for this, and as long as everyone sticks to the system....well...in time....with lots of paperwork....it will probably get sorted out!

Another gut feeling would be to contact your insurer (your health fund) and report the accident to them, and they can fight it out with your employer over whether or not they will cover it or the employer's fund has to cover it...

After 1 or 2 basic emails, sounds like it needs to be thrashed out over the phone...and try to stick to 'let's sort this out' rather than 'you stupid fool for not organising the insurance'... I'm sure you're not the first person to find themself in this position, and you won't be the last - especially as it's a 'private' employment type situation and a new employee...

Hey, the swiss system gives you three months to sign up for health insurance, backdated to the day of entry...I get the feeling that they are much more 'even handed' about providing cover, rather than just looking for any excuse to not pay, as perhaps occurs in other countries...

Guest 03.03.2011 22:03

Re: Wife's employer didn't take out accident insurance (I think)
 
Yes, time to find out the FACTS face to face before going any further.


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