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Old 23.11.2020, 16:28
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I bumped my head and need to see a doctor - who pays: accident or health insurance?

Long story short, I bumped my head in a bike crash last weekend and I'm still not feeling quite right, so I'm considering going to see a doctor.

My question is, would the cost of the appointment come out of my accident insurance or my health insurance? I'm a little worried that this could cost a fortune, especially if I get referred for an MRI scan.

I've had much worse concussions in the past (I'm a mountain biker...), so I'm pretty sure I know what the doctor's guidance will be, but better safe than sorry when it comes to one's head.
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Old 23.11.2020, 16:29
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Re: I bumped my head and need to see a doctor - who pays: accident or health insuranc

If you work, normally your accident insurance also covers accidents in your own time.
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Old 23.11.2020, 16:33
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Re: I bumped my head and need to see a doctor - who pays: accident or health insuranc

Seconding... If you are employed, this will almost definately be covered by your accident insurance. You need to inform the doctor and the employer.
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Old 23.11.2020, 16:37
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Re: I bumped my head and need to see a doctor - who pays: accident or health insuranc

Yes, I am indeed in employment currently.

My concern was that because it's now been a few days since the initial accident, it may no longer be covered under the accident insurance, thus any costs would have to come out of my health insurance.

Would the claim be handled automatically by my doctor?
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Old 23.11.2020, 16:44
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Re: I bumped my head and need to see a doctor - who pays: accident or health insuranc

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Would the claim be handled automatically by my doctor?

No, you need to inform your employer, you and/or your employer need to inform the accident insurance and you then tell your GP that this is covered by the accident insurance (and which one).
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Old 23.11.2020, 17:03
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Re: I bumped my head and need to see a doctor - who pays: accident or health insuranc

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My concern was that because it's now been a few days since the initial accident, it may no longer be covered under the accident insurance, thus any costs would have to come out of my health insurance.
No, there's no requirement that you report it immediately. It might be an issue if some months had passed, but a few days is quite normal.

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Would the claim be handled automatically by my doctor?
If it's urgent you can go direct to your doctor or a hospital, making sure they are treating it as an accident and giving them the name and details of your employer, so they won't directly bill you with anything, but you must also inform your employer directly, who will need details of the accident to open a claim with the accident insurance.
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Old 23.11.2020, 17:13
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Re: I bumped my head and need to see a doctor - who pays: accident or health insuranc

Many thanks - that's very helpful. I have just sent an email to my company's HR department.
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Old 23.11.2020, 17:29
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Re: I bumped my head and need to see a doctor - who pays: accident or health insuranc

- Go to the doctor

- Register an accident with your employer's insurer - they should provide you with an accident number

- Email / phone the accident number to your doctor's receptionist.

HTH.
Nick
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Old 23.11.2020, 17:32
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Re: I bumped my head and need to see a doctor - who pays: accident or health insuranc

And if you don‘t work, you‘re probably paying for accident insurance along with your basic health insurance. So you would call up the insurer and report the accident.
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Old 23.11.2020, 21:01
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Re: I bumped my head and need to see a doctor - who pays: accident or health insuranc

I would see a neurologist that does QEEG. If you had head injuries before could be affecting your attention therefore having more accidents. Head injuries need to be taken very seriously as they can last a whole life. Contact unique therapy.
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Old 24.11.2020, 11:54
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Re: I bumped my head and need to see a doctor - who pays: accident or health insuranc

Just a quick update - I contacted the accident insurance company provided by my employer. They took down a few details pertaining to the circumstances of the accident, gave me a reference number and told me to proceed with booking an appointment with my doctor. I was also advised that the invoice from my doctor will be automatically processed by the accident insurance, so I won't have to pay anything out of my own pocket.

Last edited by coolbeanz; 24.11.2020 at 11:54. Reason: Typo
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Old 24.11.2020, 12:24
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Re: I bumped my head and need to see a doctor - who pays: accident or health insuranc

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My concern was that because it's now been a few days since the initial accident, it may no longer be covered under the accident insurance, thus any costs would have to come out of my health insurance.
The question if it is a an accident or a general health issue is the question if the cause can be pinpointed to a specific unexpected, non-normal, sudden event and if there is a direct cause-effect relationship.

Or in legalese: «eine plötzliche, nicht beabsichtigte schädigende Einwirkung eines ungewöhnlichen äusseren Faktors auf den menschlichen Körper, die eine Beeinträchtigung der körperlichen, geistigen und psychischen Gesundheit oder den Tod zur Folge hat»
https://www.suva.ch/de-ch/news/2018/...oder-krankheit
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accident insurance, concussion, doctor billing, health insurance




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