Ordinance on the Accident Welfare of State Personnel of the Canton of Solothurn - Purpose of the Fund

1. The State maintains an accident insurance fund without its own legal personality (hereinafter referred to as the Fund) for the purpose of protecting officials employed by the State against the economic consequences of occupational and non-occupational accidents in accordance with the following provisions.

1. The fund includes all full-time and part-time state officials who are subject to the state personnel law and are elected or appointed by the public, an authority, or a canton official. Upon retirement through the State Pension Fund, they may remain members of the fund, provided they commit in writing to maintaining membership within one month after the commencement of their retirement.

2. The following persons are insured against occupational and non-occupational accidents based on collective accident insurance contracts

a) the staff of the student dormitories of Solothurn Cantonal School and the Domestic Science Seminar;

b) the spouses of caretakers;

c) household employees and cleaning personnel.

3. ...

1. The Fund insures against occupational and non-occupational accidents which result in the need for medical treatment, disability, or death.

2. Full-time officials are insured against both occupational and non-occupational accidents, while part-time officials are insured against occupational accidents.

3. Occupational accidents are defined as those described in Article 67, Paragraph 2 of the Federal Law on Health and Accident Insurance of June 13, 1911 (KUVG), and non-occupational accidents as those bodily injuries described in Article 67, Paragraph 3 KUVG.

4. Occupational accidents are equated with work-related health impairments that have been conclusively proven.

1. Determination of whether an insured accident has occurred is based on the standards applicable at the Swiss Accident Insurance Institution.

1. All operational hazards that exist during the exercise of official duties are included in the insurance.

1. Exclusion from Insurance Coverage for Non-Occupational Accidents

The extraordinary hazards and risks specified by the Swiss Accident Insurance Fund in application of Article 67, paragraph 3 of the Federal Act on Accident Insurance (KUVG), are excluded from insurance coverage for non-occupational accidents.

1. The insurance coverage extends to all accidents sustained during the term of the employment relationship. During unpaid leave, the insurance remains in effect if the insured has committed in writing, prior to the commencement of the leave, to pay both their premiums and the state's premiums for the duration of the leave.

1. The benefits provided by the fund consist of

a) Reimbursement of medical treatment costs;

b) Disability and survivors’ pensions;

c) A lump-sum funeral allowance of 3000 Swiss Francs.

2. No accident daily allowances are granted. The provisions of § 50 of the State Personnel Law of November 23, 1941, apply to the payment of salary during suspension from service.

3. Part-time officials are only entitled to the benefits under paragraph 1, subparagraphs a and b, to the extent that they are not covered by other insurance schemes, including benefits from the Old Age and Survivors’ Insurance and the Federal Disability Insurance. Lump-sum payments are converted into corresponding pensions.

4. In cases of hardship, the government council may deviate from the provisions of this ordinance. No legal remedy is available against such decisions.

1. The fund reimburses the healing costs not covered by health or third-party insurance (including disability insurance, SUVA, and military insurance), including any deductible or copayment.

2. If an official is not insured against accidents by any other fund, in the case of a non-occupational accident, the hospital stay costs are offset by those benefits which the Cantonal Health Insurance would normally provide in such a case under compulsory insurance only. For outpatient treatment, 40% of the costs are deducted.

3. Otherwise, the relevant provisions of the Swiss National Accident Insurance Fund apply (Art. 73 para. 1 KUVG).

4. For costs attributable to personal wishes of the injured person or their relatives, the injured person must contribute. The amount of this contribution is determined according to the practice of the Swiss National Accident Insurance Fund.

1. As a component of medical expenses, travel costs are recognized if they are necessarily incurred following an accident for transportation to a doctor, to the nearest hospital, or in cases of inability to walk or travel upon initial discharge from the hospital.

1. Dental damages will be compensated according to the tariff of the Swiss Accident Insurance Fund. Before treatment, a detailed cost estimate based on this tariff must be submitted to the Personnel Office for approval.

2. In case of disputes, the Executive Council shall decide.

1. The fund generally provides pensions when an accident results in the death or disability of the insured. The fund's pension is paid as a supplemental pension to the benefits of the State Pension Fund and other insurances in accordance with the following provisions.

1. Pensions are calculated based on the achievable salary in the year of the accident. The salary subject to contributions to the Old Age and Survivors Insurance, including benefits in kind, to which the injured party was entitled immediately before the accident, is considered the achievable salary. It is reassessed annually after the accident, taking into account the regular annual increase, possible cost-of-living allowances, and other general salary adjustments as per Section 35 of the Statutes of the State Pension Fund of May 6, 1957, up to retirement age, but not possible promotions. Household and child allowances are considered as long as the eligibility conditions are met.

2. For part-time officials, paragraph 1 is to be applied accordingly. The total income subject to Old Age and Survivors Insurance contributions, up to the maximum achievable salary with the state, is considered the applicable salary.

1. The fund provides disability pensions if the conditions under Article 76 of the Swiss Federal Law on Health Insurance (KUVG) are met and the accident resulted in permanent full disability, or if the insured person has been transferred to a position with a lower salary due to partial disability. No disability pensions shall be granted if the insured person can continue to perform their previous job despite partial disability and the salary has not been reduced.

1. The disability pension amounts to 100% of the creditable remuneration according to § 13, subject to the offsetting of any remaining earned income and other insurance benefits according to §§ 21 and 24, and the reduction according to § 22.

1. The fund shall provide the widow of a fatally injured insured person with a pension amounting to 60% of the assessable annual earnings. An additional pension of 5% of the assessable annual earnings of the deceased shall be granted for each child living in her household. However, the offsetting of other insurance benefits pursuant to §§ 21 and 24 and the reduction pursuant to § 22 remain reserved.

1. Each surviving child of a deceased insured person who has died in an accident, and who has already lost the other parent or later loses them, shall receive 15% of the insurable annual earnings of the deceased at the time of entitlement. The crediting of other insurance benefits pursuant to §§ 21 and 24 and the reduction according to § 22 are reserved.

1. The total amount of widow's and orphan's pensions shall not exceed 90% of the reckonable annual earnings of the accident victim.

1. The provisions of Sections 47, 48, and 49 paragraph 2 of the Statutes of the State Pension Fund dated May 6, 1957 (Entitlement to an Orphan's Pension) shall apply accordingly.

1. Pensions are granted after the cessation of full salary or wage payments. The disability pension is paid until death, and the widow's pension is paid until death or remarriage of the beneficiary. The duration of the orphan's pension is determined by § 19.

2. If the marriage was legally divorced or separated at the time of the accident, the surviving spouse only has a pension claim if the insured was obligated to support the surviving spouse. §§ 43 and 44 of the Statutes of the State Pension Fund of May 6, 1957, apply accordingly.

1. Benefits from the accident insurance to insured persons who have become wholly or partially disabled, or to survivors, shall be reduced by the amount of pensions paid out by the State Pension Fund, the Old Age and Survivors Insurance, the Disability Insurance, or the Military Insurance in connection with the insurance event.

2. Persons who do not belong to the pension insurance as fully insured members shall receive the pension to which they would be entitled as fully insured members.

1. If the recipient of a disability pension reaches the retirement age according to § 35 of the Statutes of the State Pension Fund dated May 6, 1957, the disability pension ceases, provided it exceeds the old-age pension to which he would have been entitled if he had not had an accident. The salary increases mentioned in § 13 are to be taken into account. The same applies mutatis mutandis to widow’s and orphan’s pensions at the time the accident victim would have reached retirement age. For individuals who are not fully insured members of the pension insurance, the relevant old-age pension amount applied is that which would be payable to a fully insured accident victim under the same circumstances.

1. Upon the remarriage of the widow, her remaining pension entitlement shall be compensated by a lump sum payment equivalent to three times the corresponding annual pension.

1. Insured individuals at the Swiss Accident Insurance Fund shall be treated equally to other insured individuals with respect to pensions. They must allow the pensions from the Swiss Accident Insurance Fund, and, as long as the salary is paid by the state under the State Personnel Act, the accident daily allowances from the Swiss Accident Insurance Fund to be credited in favor of the fund.

2. Officials insured only against non-occupational accidents under § 2 paragraph 2 shall be treated equally to other insured individuals with respect to pensions. The entitlement to any benefits due from the existing collective accident insurance is governed by § 38 paragraph 3.

1. In the rights of the injured party or their survivors against third parties liable for the damage, the fund shall step in up to the amount of its compensations. If a pension fund is also involved in such a case, the liability compensation shall primarily be used to cover any benefits from accident insurance. Upon request from the fund, the entitled claimants must issue a declaration of assignment.

2. If the issuance of a declaration of assignment is refused, the fund shall be released from any obligation to provide benefits.

1. Retirees of the State Pension Fund Solothurn, who continue their membership with the fund, shall pay an annual contribution of 50 francs, which is to be deducted from their pension and transferred to the accident insurance fund.

2. The full-time and part-time personnel affiliated with the fund are exempt from the obligation to contribute.

1. The state shall not make any contributions to the fund, except for the premiums for the personnel insured with the Swiss Accident Insurance Institution and pursuant to § 2 paragraph 2 of this regulation.

2. Temporary deficits of the fund must be covered by the state.

1. The Government Council may increase or decrease the contributions of the insured and the state depending on the development of the fund.

1. In the event of temporary suspension of service without termination of the employment relationship due to illness, accident, vacation, military service, and so forth, contributions shall continue to be paid in full.

2. In the case of unpaid leave, § 7 applies.

1. All decisions arising from the application of this regulation shall be made by the Government Council. The matters are prepared by the Finance Department, Personnel Office Division, and must be submitted to a tripartite commission for an opinion before being forwarded to the Government Council for approval.

2. The head of personnel shall ex officio chair the commission. Two additional members shall be elected by the Government Council from among the staff associations.

3. The accounting and asset management are entrusted to the financial administration.

1. All accidents that establish a claim to the fund must be reported to the personnel office by the injured party or their survivors without delay. The final medical certificate must be submitted to the personnel office no later than 10 days after the completion of medical treatment.

1. The Injured Party or Claimant is Obligated to

a) immediately consult a licensed physician, ensure proper care, and fully comply with the physician’s instructions in all respects;

b) provide truthful information on request to the personnel office and physicians, including trusted doctors, who are designated by the Finance Department on a case-by-case basis, regarding all known facts that, in the opinion of the personnel office, are related to the accident;

c) submit to an examination and observation by a trusted doctor at the request of the Finance Department, and fully comply with all the orders of the same;

d) allow the performance of an autopsy in the event of death, upon the request of the Finance Department.

1. Benefits may be reduced in the following cases

a) if the accident is inexcusablely not reported in a timely manner;

b) if the insured does not comply with the instructions given for their treatment;

c) pursuant to Articles 91 and 98 of the Health Insurance Act (KUVG);

d) if the assignment of liability claims is refused pursuant to § 25.

1. The Government Council is authorized to enter into reinsurance contracts against the liability consequences of this ordinance.

1. Disputes of a pecuniary nature arising from the application of this regulation shall be decided by the Insurance Court.

1. Claims against the insurer that are not made within 2 years after the occurrence of the accident are time-barred.

1. Insofar as this regulation does not establish different provisions, the KUVG shall apply mutatis mutandis as supplementary law, in particular the following are applicable

a) Article 89 concerning the summoning of survivors;

b) Article 94 concerning benefits to be granted in cases of multiple accidents;

c) Article 93 concerning the due date of benefits;

d) Article 95 concerning the commutation of pensions;

e) Article 96 paragraphs 1 and 2 concerning the securing of benefits;

f) Article 97 concerning the forfeiture of benefits;

g) Article 99 paragraph 1 concerning the recovery of benefits.

2. The powers granted in these provisions to the Swiss National Accident Insurance Fund shall be exercised in relation to cantonal benefits by the Personnel Office.

3. In place of Article 90 KUVG, the following provision applies: Contrary to the regulation provided in Article 90 KUVG, officials, employees, and workers who do not have Swiss citizenship are equated with Swiss nationals regarding welfare benefits.

1. Accident insurance contracts concluded by the canton for individual civil servants, employees, or workers, or for entire personnel categories, are to be terminated at the earliest possible date by the Finance Department, provided they concern personnel who are affiliated with the fund for both occupational and non-occupational accidents.

2. Provided that the existing credits for these insurances are not exhausted, they are to be credited to the fund.

3. Insurance benefits from these insurances, which are still due after the entry into force of this regulation, belong to the previous beneficiaries. However, the benefits will be reduced by the amounts received according to this regulation, with § 21 being applied mutatis mutandis. Lump-sum payments are to be converted into pension amounts for the purpose of settlement.

1. In the event of an amendment or repeal of this regulation, the benefits determined by the fund must not be reduced.

1. This regulation shall come into force on July 1, 1967.

2. For cases arising before this date, the fund shall not be liable.