I have been on sick leave for a while. Today I received a letter from my employer's salary continuation insurance provider. As it was in French, it took me a while to decipher, but they are basically asking for my consent for them to investigate my case by getting in touch with my doctors, health insurer etc.
Is this something I need to worry about? Is this standard practice each time there is a claim? What are they trying to find out? Can I be caught out by some rule I don't know about, or can they decide that I wasn't "sick enough", for whatever reason? If yes, would I be personally liable and have to pay back my salary, or would my employer have to reimburse them?
I guess my concern is that I have multiple sick notes covering the period, not just one, some of them from different doctors, as I couldn't always get an appointment at the same surgery and had to go elsewhere.
I couldn't find any paperwork that I received relating to this insurance. I looked up the general t&c for some products that sound similar on the insurer's website. There seem to be a few odd exclusions, such as injuries related to suicidal attempts, neither of them seem to apply to my case. And it does seem like I have to send back this form, otherwise the claim is considered void.
Many thanks in advance for any replies from people who are more knowledgeable about these things than me!
It is standard practice. When someone is on long term sick leave there is something called "case management" that kicks in. A dedicated person is allocated to the case and act as "bridge" between employee and employer. It has been shown that when such process is in place people generally are able to return to work faster.
It is a good thing in my experience (as employer).
Thank you, that is definitely helpful! I'm still trying to wrap my head around how the process works - it was this letter that made me realise/appreciate the fact that my salary currently isn't being paid by my employer, but by the insurance.
I'm assuming that the longer I stay on sick leave, the higher my chances of being sacked - now nearing the end of the first 90 days and I'm not legally protected against firing beyond that from what I understand! But what I don't understand is, if the insurance pays for my salary anyway, what incentive does my employer (and an employer in general) have to actually sack someone after the protected period if they don't want the employee to return? Will they get a less favourable quote for the insurance next year, or do they have a more direct incentive as well?
And assuming they don't want to sack me for the time being, is there a maximum period that the insurer will pay for? I'm sure this, and more, is covered in the policy document, but I don't seem to have it - should I have received this at some point, considering that the policy holder is my employer, from what I understand?
It depends on what your employment contract/HR manual says. The max is about two years from what I remember.
They are not going to sack you while you are out sick, since the notice period would have to be extended until you are in good health in any case, so you can seek employment.
Concentrate on getting better now and try not to worry.
Actually they can sack you at anytime, the insurance may however continue to pay you if they determine you should be on long term leave. From my understanding, this is not so easy to obtain.
My advice would be to establish a close relationship with your doctor who is willing to provide the insurance with all of the information on your condition. Depending on your employer, a lawyer may not be a bad idea either.
Wishing you all the best and great health to come.
There are strict rules for this, and there is only an extension after which it does not matter if one is ill or not.
During 1st year - 30 days
During 2nd till 5th year - 90 days
during 6th or more years - 180 days
If the cancellation period stretches into a new yr than the extension of the notice period will be according to the rules of the new year. And it is a right not a duty, so if the employee wants he can still leave on agreed date. And the rules of only at the end of themonth do still apply, so one day of illness quickly can bring another month of work.
And yes people can get sacked during illness and it happens.
Susie-Q your groan only shows your total lack of knowledge and your inability to learn about them.
As an insurance is paying your sick-pay it's likely that they might be liable for up to two years.
Anyone off work for more than one year might be eligible for invalidity payments (IV - at least in German).
The insurance company wants you to apply,and indeed can force an application, to the IV. If you end up being off work for more than a year and the IV office decides payments were or are due then they will reimburse the insurance company by the relevant amounts. They do this before the first year is up so someone from the IV can assess the situation and see if there's anything they can do to help you avoid being off work for more time than is necessary. If you refuse to make an application the insurance company can refuse to continue to make payments. There's nothing sinister here.
Yes you can be sacked while off sick. Someone posted the correct rules. The comments before that post are inaccurate. The salary insurance will continue to pay out for the required term while you're still sick.
A good friend has been told by their doctor to only work 50% and the insurance from AXA in this case has kicked in as the OP describes.
Their doctor told them NOT to sign the letter from the insurance company as is without first striking through one entire paragraph and writing it is only possible to liaise directly with their specific doctor who had signed the medical note. The explanation from the doctor was that if you sign it 'as is' they can gain access to your entire medical history - and not just what you're signed off for.
@OP - the paragraph from AXA they struck through was called 'Médecins et autres fournisseurs de prestations médicales' - translated as 'Doctors and other medical service providers'. The phrase written in it's place was 'Uniquement le médecin traitant' plus the name of the Doctor translated as 'Only the attending physician'. Hope that helps!
A common comment that is unfortunately not correct. Edwin has already outlined. You are protected from termination, but only for a limited period of time. But the “extend notice period until healthy” doesn’t last into infinity. And you can well be terminated even if you’re ill.
This is also not the same as the continuation of payment while on sick leave. It’s independent of the notice period. 2 years are pure luxury that not many companies outside of probably large ones offer and then it’s only because they concluded extra protection and are paying good money for it. By law it depends on where the company sits as there are three different frameworks, and how long the payment lasts depends on tenure in the company as well. And it’s not much - a few weeks in the first year, 3 months in year 5-9 etc.
The procedure you outline above is standard to avoid abuse of the system i.e. outright fraud of which there are plenty of cases. The insurance is paying your salary atm and their goal is to reintegrate you back into your job ASAP. Btw, very little choice mid- to long-term but to disclose medical records to the insurance. It’s their right to find out what’s going on - that’s how every insurance works.
Landers is correct too, IV will get into the picture very quickly.
Many thanks for the replies so far, it's very helpful! Once granted the permission, what will they exactly do? Will they just send standard questionnaires to the doctors who have treated me? Will they require me to be assessed by their own physician? What will they do if they are unhappy with something they find?
It would be quite awkward to contact my employer now to ask for more information about this insurance cover and policy, right?
Update: They have contacted my employer and sent across a whole bunch of paperwork. They seem to be very interested in finding out if there is another insurance cover that would cover the same event in some way. Also, there is a form that the doctor will need to sign upon each visit. There is a questionnaire for the doctor who first treated me (not sure why they would send it to my employer?!) about how long he expects the illness to last and stuff like that. There is also another declaration for me to sign, similar (but not identical) to the one they sent to me directly in the post. There is one very brief mention of the invalidity insurance somewhere, but it looks like they aren't pushing me in that direction yet.
Given the circumstances, I feel a bit overwhelmed and stressed by all of this, but I perfectly understand it from their point of view. I will keep you posted about what else happens. And thank you for all your replies so far.
Can I just make sure I understand this as I am confused. If I have been working for two years in Zurich and I get Sick what is the max time I can stay sick for on full pay.
Is it two years or much less? Especially if the company want to fire you after you have been sick for a month or two
Please note I am not trying to game the system but there are cuts coming in banking and I am burnt out and ina dark place with not seeing family for months due to corona and a very pressurised workload
Check your contract for supplementary sick pay conditions. It could be up to two years but probably only at 80%. This would be paid whether you get fired or not, but is subject to periodic review.
Thanks Landers - So the statutory period is 1 month in my case - That means if I get really sick I will only get paid a max of one month correct? Who would pick up the remainder?? No one?