The entitlement to insurance benefits in the event of accidents differs depending on where the accident occurred. A distinction is made between occupational accidents and non-occupational accidents.
Accidents that occur during your employment in a company.
Accidents that occur during your free time.
In this article, we explain how benefits are regulated in the event of occupational or non-occupational accidents and what you need to do to make a claim.
When am I entitled to insurance benefits for accidents?
Occupational accident ("OA")
If you have an accident while working at your place of work, you are compulsorily insured against occupational accidents with SUVA. The compulsory occupational accident insurance extends to the way to work if you do not meet the criteria for non-occupational accident insurance (see below). The insurance begins on the day you start work as agreed in your contract and ends on your last day of work. The premium for the occupational accident insurance is paid by Coople as your employer.
Non-occupational accident ("NOA")
If you have an accident during your free time, you are only insured through Coople if you meet the SUVA regulations for non-occupational accidents. This requires you to have worked for Coople for an average of more than 8 hours per week. The premium for non-occupational accidents is paid by the employee, which is why the contributions are deducted directly from your salary if you meet the conditions (visible on the salary statement as "NOA contribution"). Coverage against non-occupational accidents ends on the 31st day after your last day of work at a Coople job.
If you do not meet the criteria of working at least 8 hours per week on average, you should include the coverage for non-occupational accidents in your health insurance.
Please note that the non-occupational accident premiums will be deducted from each salary, as it is unclear in advance how much you will work throughout the year. At the end of the year, we will determine whether you have met the insurance criteria. If this is not the case, we will refund the NOA premiums at the beginning of the following year.
Good to know: if you have already reached retirement age and are working with Coople, you are also insured for occupational and non-occupational accidents, just like all other temporary employees.
What are the benefits? How long am I entitled to benefits?
From the 3rd day following the accident, 80% of the salary is paid by the insurance company. Until the end of this waiting period, Coople must pay at least 4/5 of the salary. As far as the benefits for non-occupational accidents are refused or reduced by SUVA in the case of extraordinary dangers and risks in the sense of Art. 49 and 50 of the Accident Insurance Order (OLAA), Coople is not obliged to pay wages according to Art. 324a or 324b of the Swiss Code of Obligations. The maximum insured annual salary for accident insurance is currently CHF 148'200.-. The duration of the claim is based on the legal deadlines.
How can I make a claim?
As an employee, you must report your accident to us immediately. In order for us to be able to check your claim and report it to the insurance company, we need a medical certificate from you. Without a doctor's certificate, we cannot report the case to our insurance company.* If you have any questions about the accident, you should let us know as soon as possible so that we can report the accident correctly. This is especially important in relation to the completion of the accident form, which we will send to you.
In the event of an accident, please send your medical certificate to firstname.lastname@example.org. Our team will then check your claim and, if applicable, file it with our insurance company. If the claim is accepted, you will be paid daily allowances with your next salary. You can also submit any medical bills to the insurance company with the claim number that we will send you.
*Exceptions to this rule only apply to minor accidents. Our team will be happy to advise you whether this applies in your situation.
Do I also have a claim if I no longer work with Coople?
The insurance cover for occupational accidents under the Coople job contract ends on the last day of work. Coverage for non-occupational accidents ends on the 31st day after your last day of work at a Coople. You have the possibility to extend the non-occupational accident insurance according to OLAA directly with SUVA for 6 months within this period (interim accident insurance). Further information on the interim accident insurance is available on the SUVA website. If necessary, you can take out the interim accident insurance yourself online.