A serious car accident or a minor fall?

If you have any injuries or feel pain anywhere after an accident, you are well advised to visit a doctor or hospital as soon as possible. Many medical expenses are eligible for reimbursement under one of the many forms of health insurance. 

But which insurance applies after an accident?
Which insurance policies reimburse you after an accident with bodily injuries?
accident
For a smooth reimbursement process, we advise you to follow the legally defined order.

​If you have an accident during working hours, you should logically claim against your employer's compulsory occupational accident insurance.  

In the case of an accident with bodily injuries in your private life, it is first of all the individually concluded insurance policies that compensate the costs. Common examples:

  • your accident insurance, if you knock a nail into your hand instead of the shelf,
  • your driver's insurance, in the case of a car accident,
  • your individual hospitalisation insurance,
  • ...

If someone else is responsible for causing your medical costs, you can often claim against his/her family insurance. Collective insurance (i.e. the policy taken out by your sports club) or occupational insurance (taken out by your employer) are the last in the row and serve only to repay costs that are not reimbursed elsewhere. 

For the reimbursement process to run as smoothly as possible, we advise you to follow this legally defined order.

Below we examine more closely the hospital and outpatient care insurance available to you through your employer.

When an accident lands you in the hospital emergency ward

​If you have to visit a doctor after an accident or end up in a hospital emergency ward, in principle you cannot claim against your hospitalisation insurance. The same applies to putting a broken foot or wrist in plaster. Your hospitalisation insurance reimburses you only when you are admitted to hospital and given your own bed. Are you not sure if it is an admission? Ask at the hospital.

Important detail: if you are on a biking holiday abroad and break your hand, your AG Employee Benefits hospitalisation insurance generally repays these outpatient costs. For this you do not need to be admitted to hospital: outside Belgium your insurance covers you for medical treatment for which you do not need to go to hospital.

Maybe your employer has taken out for you an outpatient care insurance in addition to the classical hospitalisation insurance. This insurance reimburses so-called 'outpatient' (or 'ambulatory') care, right through the year, even when you are not admitted to hospital. This includes visits to a general practitioner, dentist or dermatologist, or treatment by a physiotherapist, as well as medicines prescribed by a doctor.  

Check with your employer whether you benefit from such outpatient care insurance. Where you do, you can submit your medical costs in the same way as with a regular hospital admission. If your outpatient care cover runs through AG Employee Benefits, you can submit these costs by email or by post.  

More information about submitting your medical costs at AG Employee Benefits

accident
In principle your hospitalization insurance covers only those cases where you are admitted to hospital.
An accident leading to hospitalization
accident
Hospitalisation? Notify your insurer quickly.

​If you end up in the hospital after an accident, you should notify your hospitalisation insurer as soon as possible. If you are unable to do this yourself, the admission can also be reported by a family member or friend.

A hospital admission can be reported to AG Employee Benefits online, in writing or by telephone. You can find all the details here.

Do you have questions about your hospital admission? We have summarized the the most important information - before, during and after admittance - in a handy format.

If you need to recover at home for a long time after your accident and cannot work, it is possible that your statutory benefit will be supplemented by an additional amount. For this your employer needs to have taken out an occupational disability cover.

If you are not sure whether you have this cover, ask your Human Resources department.