22. September 2026

Accident Insurance for the Self-Employed: Lower Entry Threshold from 2027

The UVV Revision at a Glance – What is Changing, Who is Affected and What Questions Remain

On 26 August 2026, the Federal Council adopted a revision of the Ordinance on Accident Insurance (UVV), which will enter into force on 1 January 2027. At its core is a significant reduction of the entry threshold for voluntary accident insurance under Article 4 UVG: self-employed persons are to gain easier access to UVG coverage. This article provides a legal assessment of the changes and examines their practical implications.

1. Background: Self-Employed Persons in the Accident Insurance System

In Switzerland, all employees are compulsorily insured against occupational and non-occupational accidents as well as occupational diseases under Article 1a UVG. Self-employed persons are excluded from this compulsory insurance. They may take out voluntary insurance under Article 4(1) UVG – an option that in practice is used by only a fraction of those eligible.

A key reason lies in the current entry threshold: Article 138 UVV requires a minimum annual income of CHF 66,690 – corresponding to 45% of the maximum insured earnings (currently CHF 148,200 under Article 22(1) UVV). Those who do not reach this amount are excluded from UVG coverage and, for the consequences of accidents and occupational diseases, must rely solely on health insurance under the KVG, which provides neither daily benefits nor invalidity pensions nor integrity compensation.

Particularly affected are occupational groups with low incomes – notably in the cultural sector, the hospitality industry and personal services. In addition, women, who disproportionately often work part-time, frequently fail to reach the required minimum income.

2. What is Changing? The Revision in Detail

The revised UVV lowers the entry threshold from 45 to 30% of the maximum insured earnings. Concretely, the minimum annual income for joining voluntary accident insurance drops from CHF 66,690 to CHF 44,460. According to Federal Council estimates, this will open access to UVG coverage for approximately 40,000 self-employed persons for the first time.

A second practically relevant innovation concerns part-time work: insurers will in future be able to adjust the entry threshold to the self-employed person’s level of employment. This is particularly significant for the cultural sector, where individuals frequently hold several part-time positions simultaneously as employees and self-employed persons – so-called patchwork employment models. Until now, this group was often unable to obtain full UVG coverage through either the compulsory or the voluntary insurance scheme.

3. Why UVG Coverage? The Difference from Health Insurance

Self-employed persons without UVG insurance are covered for treatment costs in the event of accidents through compulsory health insurance under the KVG (Article 1a(2)(b) KVG). UVG coverage, however, goes considerably further:

• Daily benefits: In the event of accident-related incapacity for work, UVG daily benefits amount to 80% of insured earnings (Article 17(1) UVG). Without UVG insurance, there is no statutory entitlement to daily benefits – unless the person has made private provision.
• Invalidity pension: The UVG provides a pension entitlement from an invalidity degree of just 10% (Article 18(1) UVG). Under the disability insurance (IV), the threshold is 40% (Article 28 IVG), and the IV pension is generally lower than the UVG pension.
• Integrity compensation: For permanent significant impairments of physical, mental or psychological integrity, the UVG provides compensation (Articles 24–25 UVG). There is no comparable entitlement under health insurance.
• Medical treatment without cost-sharing: UVG medical treatment is provided without deductible or co-payment (Article 10 UVG). KVG benefits, by contrast, are subject to the usual deductible and a 10% co-payment (Article 64 KVG).

In the case of serious accidents involving prolonged incapacity for work or permanent consequences, this difference in benefits has severe consequences. Self-employed persons – unlike employees – have no employer with a duty to continue salary payments. The absence of UVG coverage can be existentially threatening for them.

4. Practical Questions: Enrolment, Deadlines and Insurers

Under Article 4(1) UVG, voluntary insurance is available to self-employed persons who are domiciled in Switzerland and work there – or at least for half of their working time. Enrolment takes place by concluding an insurance contract with a licensed insurer; depending on the sector, Suva, private accident insurers or health insurance providers may be relevant.

Under Article 136 UVV, voluntary insurance covers both occupational and non-occupational accidents. The application must be submitted before the desired insurance start date – retroactive insurance is excluded. Those wishing to benefit from the lower entry threshold should therefore contact their chosen insurer still in 2026 to ensure seamless coverage from 1 January 2027.

Premiums are based on the insured earnings, which the self-employed person sets within the range between the minimum amount (new: CHF 44,460) and the maximum amount (CHF 148,200). Insured earnings may be adjusted later. However, the amount should be set realistically: an amount set too low will result in correspondingly lower daily benefits and pensions in the event of a claim.

5. Open Questions and Limits of the Revision

The UVV revision facilitates access to voluntary accident insurance without fundamentally restructuring the system. Several questions nonetheless remain open:

First, voluntary insurance remains an opt-in solution. Self-employed persons must actively initiate enrolment – and experience shows that a considerable proportion of eligible persons fail to do so, whether due to lack of awareness, cost considerations or underestimation of accident risk. Compulsory inclusion of self-employed persons, as has been demanded politically on various occasions, is not under discussion.

Second, the part-time arrangement raises implementation questions. The possibility of adjusting the entry threshold to the level of employment is granted to insurers – but this is a permissive provision, not a mandatory one. Whether and how individual insurers will make use of this flexibility remains to be seen. If an insurer decides against adjustment, a self-employed person with a 50% workload and partial earnings of, say, CHF 30,000 remains excluded from UVG coverage – even though earnings extrapolated to full-time would exceed the entry threshold. Particularly challenging is the delineation for persons with multiple part-time positions. For instance, a musician who works 40% as an employee of an orchestra (compulsorily UVG-insured) and 30% as a self-employed music teacher: the employed portion is covered through the employer, while UVG coverage for the self-employed portion exists only if she takes out a separate voluntary insurance policy. Whether the relevant income for the entry threshold is the self-employed portion alone or total earned income is left open by the revised UVV.

Third, the revision does not resolve the more fundamental problem of status determination: whether a person is classified as self-employed or employed under social insurance law is not determined by the parties’ intentions but assessed by the OASI authorities on the basis of objective criteria on a case-by-case basis (see Article 12 ATSG). Relevant factors include the bearing of economic risk, subordination to instructions, organizational integration and operating on the market under one’s own name. Only once the competent OASI compensation office has confirmed self-employed status does access to voluntary UVG insurance become available. In the context of platform work, hybrid employment models and the gig economy, this distinction is becoming increasingly difficult. Additional momentum comes from a recent proposal by the National Council’s Social Affairs Committee that would allow the contracting parties to determine employment status contractually. The Swiss Federation of Trade Unions, the majority of employer associations and the majority of cantons reject this proposal as a threat to social security. The outcome of this debate is also relevant for the scope of the UVV revision.

6. Recent Case Law: Mixed Employment and UVG Invalidity Degree

The practical relevance of the insurance question is illustrated by the Federal Supreme Court ruling 8C_162/2025 of 27 January 2026, which is directly connected to the UVV revision.

A psychologist was employed at 60% at a hospital (compulsorily UVG-insured) and practiced 40% as a self-employed psychologist (without UVG insurance). Following an accident-related back injury, she was undisputedly restricted by 30% in her capacity to work. The accident insurer (Visana) refused an invalidity pension, arguing that the insured person could fully utilize her remaining work capacity within her 60% employed position – and therefore suffered no loss of earnings. Before the Federal Supreme Court, Visana changed its argument, contending that earnings from both activities should be combined in the income comparison. The Federal Supreme Court rejected this approach and clarified: the self-employed activity not insured under the UVG must be excluded when determining the invalidity degree – regardless of how much the insured person earns from it. The relevant basis is solely the UVG-insured employment: the pre-disability income is calculated by extrapolating the part-time salary (60%) to a full-time position; the post-disability income corresponds to 70% of this amount. Result: an invalidity degree of 30% and thus a pension entitlement.

The decision reveals a systemic problem that the UVV revision aims to at least partially alleviate: persons with mixed employment who have not insured their self-employed portion under the UVG risk a distortion of the income comparison in the invalidity assessment. Voluntary insurance of the self-employed activity would eliminate this risk and create uniform insurance coverage. The lower entry threshold facilitates precisely this step – particularly for persons whose self-employed income did not previously reach the minimum.

7. Conclusion and Recommendations

The lower entry threshold as of 1 January 2027 closes a long-standing coverage gap: approximately 40,000 self-employed persons who previously lacked access to voluntary accident insurance due to insufficient earnings will be able to obtain UVG coverage – including daily benefits, invalidity pension, integrity compensation and deductible-free medical treatment. The consultation has also shown that the actuarial financing (self-financing ratio of approximately 75%) and the design of the minimum premium require further attention. The Federal Supreme Court ruling 8C_162/2025 on mixed employment further underscores that UVG coverage for the self-employed earnings portion not only serves prevention but directly affects invalidity assessment.

Self-employed persons with annual earnings between CHF 44,460 and CHF 66,690 should promptly assess whether joining the voluntary insurance is advisable. Particular attention is warranted for persons with mixed employment – i.e. those who work part-time as employees while also being self-employed: for them, voluntary insurance of the self-employed portion can avoid inconsistencies in invalidity assessment and create uniform insurance coverage. Since retroactive insurance is excluded, contacting the chosen insurer in 2026 is recommended.

This article is for general information purposes only and does not constitute legal advice in individual cases. We are happy to assist you with an assessment of your specific situation.

 

For further information, please contact:

Alexandra Spoerri, Associate, lic. iur.