Pension provision and cover in the event of accident and illness

Self-employed persons

When taking up self-employment, it is of central importance that you provide for yourself and your family in the event of an accident or illness.

It is important to determine the monthly financial needs of the family (ideally by drawing up an expenditure budget). The family budget shows how much daily allowance must be insured and how much waiting period can be covered with the available liquidity, and thus at what conditions the insurance should be taken out.

The waiting period varies depending on the insurance company (e.g. 3, 15, 30, 90 days). The shorter the waiting period, the higher the premium. The decisive factor for the insurance company to set the premium is the
The insurance company also takes into account the existing occupational risk - the activity/industry in which the self-employed person works.

Daily accident benefit

In contrast to salary recipients in an employment relationship, a daily accident benefit does not automatically accrue from the 3rd day after the loss event in the case of self-employment. For this purpose, you must take out accidental loss of earnings insurance. Since this is not compulsory for self-employed persons, the providers have leeway in determining the insurance benefits.

Self-employed persons whose profession falls within the scope of activities of Suva (see Art. 66 UVG) have the option of taking out its entrepreneur insurance. In contrast to the mostly agreed daily allowances of 720/730 days, Suva pays a "lifelong pension" (the daily allowance entitlement only expires when the insured person is fully capable of working, when an IV pension begins or when the insured person dies).

Daily sickness benefits

Nowadays, most companies voluntarily take out collective health insurance. In this way, the employer cushions the risk of his legally regulated obligation to continue to pay wages
of the legally regulated obligation to continue paying wages to the employee who is unable to work. In sectors with collective labour agreements (e.g. gastronomy, construction, etc.), coverage by collective health insurance (according to the KVG) is mandatory.

Self-employed persons are not covered by the collective health insurance policy of their employees. If they want to cover their loss of income, they must take out a separate loss of income insurance policy for self-employed persons. The insurers also offer a wide range of options.

In many cases, insurers offer combined packages for the self-employed - i.e. accident and illness are covered in the same policy. In addition to the daily allowances, benefits such as
In addition to daily allowances, benefits such as lump-sum payments due to disability or death, worldwide insurance cover or additional medical measures can be insured. In general, it is advisable to compare
of several offers or to commission a broker to find the optimal solution for the desired package.

Self-employed activity

This also includes any shareholders who are employed in their own public limited company or limited liability company. The legal entity (the company) is the employer. The partner remunerated therein is an employee and thus insured in the collective of all other employees.

If no further agreements are made with the insurance company, the latter pays the usual daily allowances and benefits in the event of an accident or illness, based on the reported gross salary. To optimise this, the following options are available, for example:

• Arrangement of several groups of persons
• Supplementary UVG insurance
• Agreeing on a fixed wage amount (minimum wage amount)

Case study

The company he could not draw his full salary for the last few months, now he has an accident. The subsistence minimum for his family is higher than the salary he received. With a fixed salary sum agreed in advance, underinsurance can be prevented, as the daily allowance is calculated on this basis, even if the average gross salary of the last few months has been lower.

If the employer only has the partner as a wage earner, it is not possible to take out collective health insurance without answering health questions. The insurance company may refuse the affiliation or exclude certain risks. This can be a problem even if there are only a few employees. Above a certain size, however, this unequal treatment no longer applies and everyone is insured under the same conditions.

Conclusion

A clear needs analysis of what you and your family need financially in the event of a prolonged absence due to accident and illness is the basis of your optimal insurance solution.

This article previously appeared in CORE Newsletter 30 of December 2021.

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Maria Peduto-Bächler

Procurator
Head of Team Alternate
Certified Fiduciary, Federal Diploma of Higher Education

T +41 26 492 78 23
mba@core-partner.ch