Overview of all KLE cases stories

For more details, see Chapter 5 Reporting a new event - KLE case stories in detail and Other story parts in detail.

Company’s stories for the insurer


Registration is the first company’s notification of the insurer. It initiates the process between the company and the insurer. .

Incapacity to perform duties

A complete history of incapacity to perform duties is always submitted here. Depending on the configuration, a change can be a correction (e.g., the incapacity degree is changed for a period of time that has already been reported) or an extension (e.g., the duration of the incapacity is extended).

Return to work

This part is only required directly by the insurer and cannot be initiated by the company. The return to work is filled in by the company in the Incapacity to perform duties story.

Medical treatment

Registration of the first doctor/hospital attended; other contacts can be recorded for follow-up treatments.

Other insurers

Information about other insurances with a different or additional entitlement to benefits at the time of the event is determined in this part.

Payment details

The company’s or the insured person’s payment details are trans-ferred in this part.

The insurer usually transfers daily benefits to the company’s pay-ment address known to it. Therefore, this story can only be used on request or when payment details have changed.

For person’s payment details:

Notification of payment details including the date when the insur-er’s daily allowance should no longer be paid to the company, but should be paid to the person.

Working hours lost

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).

Accident description

Notification of accident (type, course and injury).


The Dialog feature is used to exchange simple messages (similar to SMS or e-mail) between the insurer and the company. This story triggered by the company is one-sided and does not require any replies.


File transfer, e.g., work incapacity certificates, etc.

Available formats: *.pdf, *.png, *.jpeg, *.jpg, *.tif, *.bmp

Other story parts


Employment contract

Additional information on the person’s employment contract is submitted in this part. The contents of fields Employment contract, Education and Occupational status that are required for the WSS (Swiss wage structure survey of the Federal Statistical Office) come from the Statistics tab.

Salary data

If there is an incapacity to perform duties, wage data is requested and must be submitted along. Daily allowance calculation is based on the correspondingly set up and supplied wage types or their posting. See also Chapter One-time setup - Salary types

Short-time work

Notification in the event of short-time work.

Special code

Individual codes can be reported or requested in this part for a wide variety of purposes as agreed between the insurer and the company. For example, evaluation related to the company’s internal cost centers.

Other employers

The company will only send this story to accident insurer if the insured person was employed by one or more other employers at the time of the event.

Salary raise

This story can be used to report salary raises in the course of an event. In many cases, a salary raise during incapacity to perform duties does not lead to an adjustment of daily allowance amount due to legal or contractual provisions. In case of doubt, the insurer can be asked via a dialog whether the report is necessary at all prior to reporting a “Salary raise”.

Changed personal data

This story can be used to report, e.g., address change, marital status, in the course of an event.

Family member

This story can be used to report to the accident insurer that the person is a special case with regard to the category of the in-sured.

Voluntary entrepreneur in-surance

This story can be used to report to the accident insurer that the person is a special case with regard to the category of the insured.  


This story can be used to report to the accident insurer that the person is a special case with regard to the category of the insured.

Process change

Process change can be used to close or cancel an event reported by the company. A case may NEVER be closed or canceled dur-ing the course of a claim if the insurer is not informed.

Insurer’s stories for the company

Daily allowance

This is the detailed daily allowance statement.

Daily allowance amount

This story is used to report daily allowance amount in the course of an event.  


This story mostly requires a response.


Daily allowance corrections that require a refund to the insurance company.