Unpaid premiums to catch up on

Unpaid premiums to catch up on

"I left my job just over a year ago to do a specialisation. I was surprised to receive a letter the other day. What about it? Does it have the right to do so?

Jeanne, Carouge

Under the Federal Law on Accident Insurance (LAA), insurance cover is compulsory for salaried employees working in Switzerland, those working at home, apprentices, trainees, volunteers, people working in trade schools or sheltered workshops, domestic servants and people employed as cleaners in private households. In these cases, the premiums are paid by the employer, who can deduct the portion relating to non-occupational accidents from the salary. Unemployed persons are also covered by compulsory insurance. Accident insurance is optional for self-employed persons domiciled in Switzerland, and for their family members who work for the company. People who are not employed, such as housewives and househusbands, children, students and pensioners, are not insured under this law. They are, however, insured against accidents under the Federal Health Insurance Act (LaMal).

The relationship between the two types of insurance is relatively straightforward: although health insurance provides benefits in the event of sickness, maternity and accident, it only covers accidents if the insured person has no other insurance cover. Therefore, if the insured person is fully covered for this risk, on a compulsory basis, under the LAA/UVG, he/she may request that accident cover within the meaning of the LaMal be suspended, in which case premiums will be reduced proportionately. As soon as LAA/UVG cover ceases in whole or in part, accidents are covered by the health insurance company, which assumes the costs of any accidents it insured before the cover was suspended.

Before termination of employment or entitlement to unemployment benefit, the employer or unemployment insurance company will inform the insured in writing that he must inform the health insurer when accident cover ceases. The insured must notify the health insurer within one month.

If the insured has not fulfilled his obligation, the health insurer may demand payment of the part of the premium corresponding to accident cover, including default interest, for the period between the end of cover within the meaning of the LAA/UVG and the time when he became aware of it. If the employer or the unemployment insurance company have not correctly informed the insured, the health insurer may assert the same claims against them.