Occupational accidents continue to decline

In occupational accident insurance, the number of accidents has fallen continuously by a total of 5.5 percent since 2011. This is despite the fact that the number of full-time employees has increased over this period. The occupational accident risk (number of accidents per 1,000 full-time employees) has also been declining for years. Suva attributes this decline on the one hand to its prevention work in the area of occupational safety. On the other hand, high-risk activities are generally decreasing as a result of ongoing structural change - for example, due to the increase in automated processes.

Good result despite higher costs

Suva incurred daily allowance costs of CHF 1.35 billion in 2016, 3.5 percent more than in the previous year. However, the average duration of daily allowance payments remained stable at around 40 days. The higher daily allowance costs are partly due to the fact that more cases were settled in 2016 (+2.6 percent), namely a total of almost 231,000 cases. The reason for this was that Suva switched to new claims settlement software in 2015. This changeover led to backlogs of work that Suva worked through in 2016, which is now reflected in the figures. Furthermore, the daily allowance costs were influenced by the general increase in average wages and the increase in the maximum insured earnings as of January 1, 2016.

Suva's software changeover also had an impact on treatment costs. It also led to an increase in the number of cases billed (+2.5 percent). Suva paid CHF 1.21 billion for medical and therapeutic services. This represents an increase of 1.9 percent in treatment costs. On the other hand, treatment costs per case decreased slightly to around 2,000 Swiss francs. Against this background, it is possible to speak of a good result, says Daniel Roscher, member of Suva's management board. He sees the main reason for this in the fact that Suva was able to provide targeted support to its accident victims more quickly last year. In general, Suva is able to control costs to a certain extent thanks to system-related advantages, because it works according to the so-called benefit-in-kind principle. As a result, it can already exert influence during treatment, as insured persons receive a medical service provided by the accident insurance company. "We can help decide whether a medical service is appropriate for a particular patient in his or her situation or not," Roscher says. As a result, Suva has better control options, can consistently monitor bills and is not a passive paying agency. "This has a positive impact on premiums."

Systematic invoice controls

Suva is strongly committed to keeping rising medical costs under control. Last year, for example, it checked around 2.4 million invoices electronically. Of these, the system sorted out around 1 million invoices due to anomalies. These were manually checked by 60 Suva medical cost specialists. "They primarily check whether the services received are accident-related, match the diagnosis and whether they correspond to the tariff," says Peter Diermann, head of insurance benefits at Suva. Thanks to these systematic invoice checks, Suva only pays for benefits that are justified. "Because today's control is tomorrow's premium."

In 2016, Suva rejected 280,000 invoices amounting to 210 million Swiss francs. Most of the rejected claims were for duplicate invoices, rejected and closed cases, or uninsured benefits such as migraine medication.

Higher pension costs

A total of around 88,000 people currently receive a pension from Suva. A good 80 percent of these are disability pensions and just under a fifth are survivors' pensions. Each month, around 122 million francs are paid out in pensions to those entitled to them. At 1670, the number of new disability pensions is in line with the last five years (previous year 1606). On average, a new lifelong disability pension last year required actuarial reserves of 336,000 francs (previous year 322,500 francs). Due to the low interest rate environment, Suva needs more funds to capitalize the new pensions. In addition, the life expectancy of pensioners is increasing, which also contributes to an additional capital requirement. All these factors led to an increase in the total cost of new disability pensions from CHF 518 million to CHF 561 million in 2016.

Source: Suva