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Other KLE case stories must be filled in after the initial report if it has not already been done.
Stories marked with * are provided with more details according to the table.
Story - Name
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Use for accident
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Use for KTG
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Incapacity to perform duties
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Only required in the event of in-capacity to perform duties. Up to date can be left open. Record later incapacity to perform duties that changed and submit again.
Return to work is recorded here.
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Only required when registering birth benefits with indication of the birthdate.
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*Return to work
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This part is only required directly by the insurer and cannot be filled. The return to work is filled in the Incapacity to perform duties story.
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*Medical treatment
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The first doctor or hospital at-tended (initial contact) and other contacts. (Follow-up treatments)
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The first doctor or hospital at-tended (initial contact) and other contacts. (Follow-up treatments)
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*Other insurers
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Information about other insuranc-es with a different or additional entitlement to benefits at the time of the event.
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Information about other insuranc-es with a different or additional entitlement to benefits at the time of the event.
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Payment details
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Usually known already and does not need to be provided. Only when an employee resigns or when the company has new bank details.
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Usually known already and does not need to be provided. Only when an employee resigns or when the company has new bank details.
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*Working hours lost
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Only report if the company ex-pects compensation and the in-surer provides for it.
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Only report if the company ex-pects compensation and the in-surer provides for it.
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*Accident description
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Mandatory requirement that can only be filled in with an exact or an approximate accident date.
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none
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*Dialog
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Used to exchange simple mes-sages (similar to SMS or e-mail), tasks between the insurer and the company.
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Used to exchange simple mes-sages (similar to SMS or e-mail), tasks between the insurer and the company.
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Attachments
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PDF file transfer is possible. E.g., work incapacity certificates, etc. .
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PDF file transfer is possible. E.g., work incapacity certificates, etc.
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Return to work
If necessary, this part is only required directly by the insurer and cannot be filled. The Return to work can be filled in by the company in the Incapacity to perform duties story only.
If the ‘Return to work’ story is required by the insurer, the Return to work field features the options below:
•Started work
Record the date activities were effectively resumed in full.
•Expected reinstatement
Expected last day of incapacity to perform duties if an approximate date is already known. Otherwise use Estimated reinstatement.
•Estimated reinstatement
If activities have not yet been fully resumed and no reinstatement date is known, the expected duration of the entire incapacity to perform duties should be stated (estimate). => Expected duration of incapacity to perform duties selection unknown, up to 30 days, more than 30 days.
Medical treatment
If the first doctor or hospital attended was initially reported incorrectly, another doctor/hospital can be reported as the initial contact during subsequent reporting. The initial contact is marked correspondingly with a cross when the box is checked. Other contacts can be recorded. However, there is only one initial contact.
Other insurers
Information about other insurances with a different or additional entitlement to benefits at the time of the event is required in this part.
•SUVA
•Other obligatory accident insurer
•Daily sickness benefit insurer
•Disability insurance
•AHV
•Occupational pension fund
•ALV
•Maternity insurance
•Other
Working hours lost
Absences can be reported or... requested in this part. Absences are individual working hours lost by a person at least partially able to work related to the insured event (e.g., doctor appointment, physiotherapy). => also see Special cases - Working hours lost
Accident description
Event date and description
In the event of an occupational accident, the subject matter concerned can be added to a free text field.
In the event of a non-occupational accident, the last working day before the accident must also be reported and the activity during which the accident occurred must be stated.
In the event of an occupational disease, the time of the accident does not have to be recorded.
In the event of death, the date of death must be stated and whether it was an occupational accident or a non-occupational accident. In the event of a non-occupational accident, the last working day before the accident must also be reported.
In the event of a recurrence, the insurance case ID (claim number) of the insurer covering the event that the relapse is based on must be specified (base case). In addition, the recurrence date must be provided.
Affected body parts
If left, right or both sides of the body are selected, the affected body parts must be selected under Assigned body part and the type of accident must be determined.
If Unassigned body area applies, it should be selected from the Unassigned body part list. E.g., heart. Further information can be provided in the Other type of injury field.
=> see also Special cases - Reporting accidents with unassigned body parts
Dialog
The dialog is used by companies or insurers for notification and appropriate response. It is used to send simple messages (similar to SMS or email), tasks, up to simple standardized form templates (e.g., job description). .
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