Incident note

Fill in the following fields with your data in order to complete the incident note.

Employer & Policy

Employer

Data in processing...

Policy details

   
Data in processing...

Contact person

   
Data in processing...

Company details

   
Data in processing...

Insured person

Contact data of employee

   
Data in processing...

Personal details

   
Data in processing...

Employment data

   
Data in processing...

Working hours

   
Data in processing...

Basic contractual wage

   
Data in processing...

Further social insurance

Does the insured person receive a daily allowance or a pension?

   
Data in processing...

Incapacity to work

Incapacity to work

   
Data in processing...

Work resumption


   
Data in processing...

Treatment

Initial treatment by doctor/hospital


   
Data in processing...

Subsequent treatment by doctor/hospital


   
Data in processing...

Comment

Comment for insurance

Characters remaining:

Data in processing...

Send and Print

          
Data in processing...

Submit attachment

Submit attachment

The document transmission is available only after successful sending of the incident.

Operator help

Have you got a question or suggestion for SUNETOnline?

Sunet-Helpdesk +41 41 455 43 03 (Mo-Fr, 8:00 - 12:00 and 13:00 - 17:00)

Version: 22500