Burnout at work: employer responsibilities and insurance coverage in Switzerland

Burnout at work: employer responsibilities and insurance coverage in Switzerland

A work stoppage due to burnout quickly puts a small or medium-sized enterprise (SME) under pressure: business continuity, workload distribution, HR decisions, and immediate financial questions. The reflex is often to look for "which insurance covers burnout." The right approach is different: treat the inability to work as a risk scenario, clarify the employer's responsibilities, and then verify which benefits actually apply.

The aim of this article is to help you decide what to put in place before the next case, what to do during the shutdown, and what to document to remain consistent, responsive, and clear with your insurance company.

Burnout at work: defining the risk in order to make a decision

A work-related phenomenon, not a medical label to be dealt with.

The World Health Organization (WHO) describes burnout in the ICD-11 as a phenomenon occurring within the workplace context, and specifies that it is not classified as a disease. It refers to chronic work-related stress that has not been effectively managed, with typical manifestations including exhaustion, detachment/cynicism, and decreased productivity.

The consequence for an SME is that you don't "manage" a word, you manage a situation of incapacity for work and the organizational factors that contribute to it.

A psychosocial risk, therefore a matter of work organization

SECO points out that psychosocial risks include stress and burnout, and that they are linked in particular to inadequate work organization and an unfavorable social environment. It also highlights their potential effects on the company (e.g., performance and costs).

Suva adds an important point for piloting: the causes are often both professional and personal.

This explains why prevention and documentation (and not just insurance) make a difference.

Employer responsibilities in Switzerland: protecting mental health and taking action

The legal framework: health, overwork, integrity

The Labour Act requires the employer to protect the health of workers and to organize work in such a way as to protect them, as far as possible, from dangers threatening their health and from overwork.

OLT 3 specifies that the employer must take all necessary measures to ensure and improve the protection of physical and mental health.

It also frames the logic of monitoring (controlling the effectiveness of measures) and informing/instructing workers on potential physical and psychological risks and on protective measures.

Finally, the Code of Obligations (art. 328) establishes the employer's duty to protect and respect the personality of the worker, in particular his health and integrity.

Operational translation: what is expected of a “managed” SME

These texts do not demand perfection. They require a coherent, proportionate, and traceable approach. In concrete terms, a solid SME does three things.

Pilot

• Clarify the workload rules (priorities, deadlines, trade-offs) and the warning signs that trigger a discussion

• Provide managers with a framework: what to observe, how to speak, when to escalate to HR

• Treat breaches of integrity (conflicts, pressure, harassment) as risks, with a procedure

Document

• Keep track of work organization decisions and prevention measures (not medical details)

• be able to demonstrate “what was decided and done” if a question arises (inspection, insurer, dispute)

Follow

SECO reminds us that the labour inspectorate monitors compliance with the duty of protection, and that psychosocial risks are among the major themes of the implementing bodies.

Without follow-up, prevention remains an intention.

Burnout insurance coverage: what is activated in practice

Burnout is not an insurance guarantee. It is, more often than not, an inability to work due to illness, with a chain of mechanisms that follow one another.

Maintaining salary: the legal minimum

The Swiss Code of Obligations stipulates that if an employee is unable to work through no fault of their own (particularly due to illness), the employer must pay their salary for a limited period, subject to certain conditions. The text specifies a minimum of three weeks during the first year of service, followed by a longer period determined equitably based on the length of the employment relationship and the circumstances.

The SME Portal reiterates this principle and explicitly links it to the CO.

Key point: without daily allowance insurance, the financial risk depends on the duration, relapses and multiple cases.

Daily allowances: LAMal or LCA, and parameters to be read “like a contract”

The FOPH distinguishes between two frameworks: daily allowances according to LAMal (social insurance) or according to LCA (private contract).

Under the Swiss Federal Law on Health Insurance (LAMal), the Federal Office of Public Health (FOPH) specifies that, in the case of a 50% disability, benefits must be paid for at least 720 days within a 900-day period. It also clarifies that LAMal does not stipulate a minimum amount, and that many insured individuals switch to solutions governed by the Swiss Federal Law on Insurance Contracts (LCA).

On the practical side for SMEs, the SME Portal indicates that, when daily allowance insurance is provided, “most” insurances pay at least 80% of the salary for 720 or 730 days out of 900 days.

Use as a reading checklist, not as a promise: rate, waiting time, duration, exclusions, announcement procedure and case management.

Accident insurance: avoid the wrong turn

Suva is clear: burnout is not considered an occupational disease and is therefore not covered by accident insurance; it refers to it as a work-related health disorder.

In practice, the dominant scenario is therefore illness, not accident. This avoids months wasted waiting for a qualification that never comes.

Mini case study 1: sudden work stoppage, missing or misunderstood daily sickness insurance

Symptom: documented incapacity, team disorganization, “we’ll see with the insurance”.

Decisions:

• HR stabilizes the process (certificate, confidentiality, point of contact, communication rules). The SME Portal reminds us that the employer can, in principle, require a medical certificate from the first day, even if contracts sometimes stipulate a deadline.

• CFO quickly checks the existence and parameters of an IJ, otherwise manages the maintenance of salary and continuity.

• Management arbitrates the workload to avoid a cascading overload (prevention by the organization).

Mini case study 2: Waiting for "accident" care that doesn't arrive

Symptom: the stoppage is perceived as “100% work-related”, and the company believes that accident insurance will pay.

Decisions:

• To clarify: Suva indicates that burnout is not an occupational disease covered by accident insurance.

• switch the file to the correct circuit: salary and IJ (LAMal/LCA) with a compliant announcement.

• document the organizational measures taken (workload, objectives, adjustments) to remain consistent and avoid the case turning into a “non-evident” liability debate.

Guidelines and checklist

What needs to be documented

Objective: to prove the consistency between risk, decisions and measures, without over-documenting sensitive data.

• “Health absences” procedure (roles, confidentiality, points of contact, steps).

• Decisions regarding work organization: priorities, workload, schedules, adjustments during peak periods.

• Prevention and information measures: manager briefings, reminders of reporting channels.

• Traceability of alerts and actions: observed fact, action decided, follow-up (factual, dated).

• Insurance file: announcements, correspondence, decisions, documents transmitted (controlled list).

• Return to work: recovery plan, adjustments, milestones, monitoring points.

These elements support the obligation to protect the physical and mental health (LTr/OLT 3) and the personality of the worker (CO).

Common mistakes and how to avoid them

• Expecting everything from the insurance: work organization and continuity are decided right away.

• Confusing “work-related” and “accident insurance”: Suva reminds us that burnout is not an occupational disease covered by accident insurance.

• Discovering the maintenance of salary too late: secure the reading CO and the articulation with IJ before the case.

• Documenting in reverse: keep unnecessary medical details, but not the decisions regarding charge, priorities, and measures.

• Going back to “business as usual”: without real adjustment, the risk of relapse increases.

Questions to ask your insurer/broker

1. Is our IJ under LAMal or under LCA, and what are the consequences (admission, reservations, exclusions)?

2. What is the waiting period, the maximum benefit duration, and the management of partial incapacity?

3. What documents are required when announcing and during the follow-up of a case related to a mental health condition?

4. What notification deadlines must we respect to avoid a refusal of service?

5. How does the daily allowance interact with the maintenance of salary provided for by the CO and our employment contract?

6. What support is planned (case management, network, recovery recommendations)?

7. What happens in case of relapse after resumption, and what are the rules for continuity of coverage?

8. How do you deal with situations where several factors (work and private) are involved?

9. Regarding civil liability: what scope, what exclusions, what reporting process in case of a complaint?

10. What prevention measures or tools do you propose (SECO, Suva, internal programs), and under what conditions?

Conclusion

Workplace burnout is managed as a risk: protecting mental health, organizing work in a sustainable way, and being able to demonstrate this. From an insurance perspective, clarity comes from a simple overview: maintaining salary, daily allowances (LAMal/LCA), limits of accident insurance, and the potential role of civil liability.

A useful next step is to review your HR processes and contracts (daily allowances, compensation, procedures), then create a quick reference guide and a documentation checklist. This saves time when the company needs it most.