Notification
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Registration is the first company’s notification of the insurer. It initiates the process between the company and the insurer. .
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Incapacity to perform duties
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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).
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Return to work
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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.
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Medical treatment
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Registration of the first doctor/hospital attended; other contacts can be recorded for follow-up treatments.
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Other insurers
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Information about other insurances with a different or additional entitlement to benefits at the time of the event is determined in this part.
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Payment details
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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.
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Working hours lost
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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).
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Accident description
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Notification of accident (type, course and injury).
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Dialog
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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.
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Attachments
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File transfer, e.g., work incapacity certificates, etc.
Available formats: *.pdf, *.png, *.jpeg, *.jpg, *.tif, *.bmp
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Other story parts
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Employment contract
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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.
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Salary data
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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
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Short-time work
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Notification in the event of short-time work.
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Special code
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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.
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Other employers
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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.
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Salary raise
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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”.
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Changed personal data
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This story can be used to report, e.g., address change, marital status, in the course of an event.
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Family member
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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.
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Voluntary entrepreneur in-surance
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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.
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Agreement
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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.
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Process change
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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.
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