When you are unemployed, Suva automatically insures you against accidents for as long as you are entitled to unemployment benefit, and for up to 31 days after that entitlement ends. After that there are two routes: extend this cover by up to six months with an extension by agreement (Abredeversicherung), taken out and paid before the deadline, or let accidents return to your health insurance, which must then be told.
While you are employed, the employer insures its employees against accidents, and the health insurer can suspend its own accident cover. When you are unemployed, this arrangement changes: another insurer takes over for accidents, and illness is compensated under other rules. Each transition has its own deadlines.
This guide does not deal with the unemployment benefit itself, its conditions or its amount: those are the rules of unemployment insurance, on which the unemployment fund and the regional employment office provide information. It covers what happens, in the meantime, to accident and health insurance.
Accidents: Suva takes over
A person who meets the conditions for receiving unemployment benefit is insured against accidents with Suva. Suva puts it simply: the person is then automatically insured, with no particular formalities. A premium is deducted: according to Suva, it amounts to 3.70% of the unemployment benefit, of which 2.47% is deducted directly from the benefit.
In the event of an accident, the State Secretariat for Economic Affairs (SECO) states that unemployment insurance continues to pay the benefit for three days, including the day of the accident, after which Suva pays daily allowances. The accident insurance law (UVG/LAA) provides that these allowances are paid even while waiting periods or days of suspension from unemployment insurance are running.
When this cover ends
For unemployed people, accident insurance ceases to have effect at the end of the 31st day following the day on which they last meet the conditions for entitlement to benefit, or last receive a benefit. Suva adds that the cover ends even if labour-market measures are still under way.
An example shows how long this period is. If a person receives their last unemployment benefit on 31 March, the first of the 31 days is 1 April, and the 31st falls on 1 May: Suva's accident cover ends at the end of that day. Without an extension by agreement, an accident on 2 May is no longer covered by Suva: the law provides that it is then covered by the health insurance, with its deductible and co-payment.
Extension by agreement or health insurer: what changes
The law obliges the accident insurer to offer an extension of up to six months by means of a special agreement; for unemployed people, that insurer is Suva. The extension must be taken out and paid before the compulsory cover ends, which means within the 31 days. Once that period has passed, Suva says it can no longer offer it: all that remains is the health insurance's accident cover.
The two do not pay for the same things. The extension by agreement prolongs cover under the UVG/LAA: according to Suva, medical treatment is paid for with no deductible and no co-payment, and daily allowances or pensions may be granted. Under the health insurance, an accident is reimbursed like an illness, with the deductible you chose and the co-payment. Compulsory health care insurance pays no daily allowances: these belong to a separate, voluntary insurance. For someone who no longer has a salary, the gap is felt above all when an accident keeps them off work for a long time.
Suva also sets the price and the terms. A monthly premium costs 65 francs; the extension is taken out for at least one month, can be extended month by month up to six, and can be neither cancelled nor refunded. To stay covered beyond six months, Suva advises asking the health insurer to include accident cover.
What separates the two routes, then, is duration, six months at most on one side and no limit on the other, and the extent of benefits when you cannot work.
The health insurer must be told
The accident cover of the health insurance can be suspended as long as the insured person is fully covered by compulsory accident insurance. But accidents are covered by the health insurance again as soon as that cover ceases, wholly or in part. The health insurer therefore needs to know.
The law governs how this information is given. The employer informs a person leaving their job, in writing, that they must report it to their health insurer; the same obligation falls on unemployment insurance when entitlement to its benefits expires without a new job. The insured person then has one month to make this report. If they have not made it, the health insurer may claim the share of the premium corresponding to accident cover, with default interest.
The reverse also applies on returning to work. As soon as a new employer insures the person against accidents, the health insurance cover can be suspended again, at the insured person's written request and with proof of the new cover; the suspension takes effect on the first day of the following month at the earliest, and the insurer then reduces the premium. This step is not automatic: without a request, the premium continues to include accident cover.
Falling ill while unemployed
An unemployed person who becomes temporarily unable to work, wholly or partly, because of illness, accident or pregnancy, keeps their entitlement to the full benefit if they meet the other conditions. This entitlement lasts at most until the 30th day after the incapacity begins, and is limited to 44 daily allowances within the framework period.
In practice, an incapacity for work lasting two weeks continues to be compensated by unemployment insurance as though the person were available for placement. A longer incapacity, on the other hand, exhausts this entitlement after the 30th day, and the total of 44 daily allowances applies to all the incapacities in the period, not to each of them.
Daily allowances paid by a health or accident insurer are deducted from the unemployment benefit. Beyond these 44 allowances, it is a sickness daily-allowance insurance, if the person has one, that can take over; otherwise, income is no longer guaranteed by unemployment insurance.
What is useful to do
- As soon as you register as unemployed, keep the documents showing your entitlement to benefit: they also prove your accident cover with Suva.
- Within the 31 days after your entitlement ends, choose between the extension by agreement, to be taken out and paid before the deadline, and the health insurer's accident cover.
- When your entitlement ends, or when you find a job again, report the change to your health insurer in writing so that accident cover is reactivated or suspended again.
- In the event of a long illness, check whether a daily-allowance insurance exists, individual or taken over from an employer's group contract.