Reporting a new event

Registration (notification) can be used by the company to report an event to the insurer with a minimal data record, even if the event date is still missing.

This way, the company can report the event promptly and receive claim number (insurance case ID) from the insurer.

 

A new accident event can be reported as follows. (Illness cannot be reported at the moment.)

 

=> open the relevant employee in the personnel list and open a new case via Personnel - KLE Case Management.

 

Select New accident in the menu above and fill in the data in the General menu.

 

If an incorrect incident date has been reported by mistake, it can be overwritten and transmitted again. The case is only activated by the insurer when a complete report is submitted (all mandatory stories).

In an additional hint by means of a 'dialogue' story, the reason of the mutated incident date could be announced.

 

 

Field description

 

General

Explanation - Action

Informationen

Incident date type

Being clarified - approximate - exact, select corresponding situation

Depending on whether the inci-dent date is known at the time of reporting with ‘Being clari-fied’, the story Accident de-scription and Incapacity to per-form duties is not possible.

Incident date

Record accident date or leave blank if not yet known

Record the accident date or leave it blank, if it is not yet known when the incident date type is ‘exact’ or ‘approximate’, a date is required.

Type of accident

Select the corresponding type

- Accident BU - Accident NBU

- Occupational disease

- Death BU - Death NBU

Work hours

Irregular - regular

This is also explained in menu One-time setup - Wage type man-agement / Wage type assignment

An hourly wage earner is usual-ly set to irregular. However, if s/he has individually agreed weekly working hours, ‘regular’ must be selected so that the contractually agreed wage, and not the actual wage bill for the last 12 months, is reported.

Monthly wage earners are set to regular.

No incapacity to perform duties

Not activated by default = Accident with incapacity to perform duties

Must be set to inactive if it is a minor accident without incapac-ity to perform duties.

Recurrence date

new, later date, after the initial inci-dent date

Only required in the event of a report on recurrence.

Recurrence case with the same employer

Select the corresponding case

Selection of all the employee’s reported cases.

Recurrence after the change of employer

… Select will take you to the com-pany’s UVG insurance details. En-ter the claim number of another insurance company in the Recur-rence insurance case ID field

In the event of a recurrence, the insurance company that was the service provider for the base case must pay for it. Therefore, enter the ‘old claim number’ here.

Test case

Active by default and must be deactivated for reporting

Can be used for training and testing purposes. No claim is opened for an insurer.

Sync with Direct

Case is synchronized with SwissSalary Direct.

SwissSalary Direct Self-service Portal must be set up

If SwissSalary Direct is used, the new case can be sent to the SwissSalary Direct Self-service Portal by checking the ‘Synchronize with Direct’ box in the General menu, so that the person who has had an accident can view the event report and possibly add to it. The claim number (see the Insurance Claim column) is displayed in the overview. This number can be provided to the medical contact and used to obtain medicines from a pharmacy.
 

The event report can then be submitted. However, we recommend filling in information also for stories ‘Incapacity to perform duties’, ‘Medical treatment’ and ‘Accident description’ and, if available, also send work incapacity certificate. The view at the bottom of KLE Case Stories will then change to ‘confirmed’.

Reports without an exact incident date can also be submitted. The Case synchronized confirmation message appears.

The report is confirmed with its claim number (insurance case ID) filled in Insurance details (right window).

 

After the initial report, the insurer may request other parts. They are marked in red and have a deadline. These parts are stories that the insurer dynamically requests from the company over the course of the case.

Missing information must be filled in via different stories and re-submitted.

 

While parts have not yet been transmitted, they can be deleted via ‘Manage’ in case stories. If an incorrect incident date or wrong incapacity to perform duties has already been reported, stories may no longer be deleted.

=> For more information on stories, see chapter Overview of all KLE cases stories and KLE case stories in detai