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Overview insurance coverage in case of coronavirus COVID-19

In Switzerland, the insurance coverage in the area of employee benefits shows basically no gaps related to COVID:

  • Medical care is covered (everyone’s own health insurance); depending on individual needs, the individual person is also insured for a daily hospital allowance.
  • Continued payment of wages in the event of absence due to illness (medical certificate) is regulated (OR Art. 324); insurance cover (daily sickness allowance) takes effect after the waiting period has expired.
  • In occupations with a higher risk of infection (e.g. medical care) an illness might be evaluated as “occupational illness”. In this case coverage would be given by the mandatory accident policy (UVG/LAA). A specific clarification needs to be accomplished on a case- by- case basis.
  • The sickness benefits covered in the pension plan (risk benefits for long-term disability and life) are covered regularly.

Please note that in case of a pandemic, the federal government could enact emergency measures that would overrule this if the financial situation of pension funds became dire. A possible measure they could take would for example be to limit the benefits paid out of the fund to a certain level.

  • The only unknown situation is when employees are going (have to go) into self-quarantine "as a precaution". They cannot work, but are not sick either. It is to be assumed here that there is also a duty to continue to pay wages according to the Swiss code of obligations. Only in the case that the employee is absent from work based on his/her own decision (he/she is afraid) there might be no wage entitlement for the absences. Link to the topic (in French):
    https://www.sgv-usam.ch/fr/grands-axes-politiques/march%C3%A9-du-travail/sous-page/consid%C3%A9rations-juridiques-quant-aux-r%C3%A9percussions-possibles-du-coronavirus

Authors


Head of Health & Benefits Switzerland

Urs Bannwart
Director, Retirement, Switzerland

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