Who is insured?

Employees and public servants

The premise for being covered by the compulsory Workers’ Compensation Insurance is work performed for pay. The insurance therefore covers employees, public servants and other persons in similar employment relationships. The acts applicable to employment relationships are listed in the Workers’ Compensation Act (TyTAL).

The existence of an employment relationship is interpreted in accordance with the Employment Contracts Act. An employment relationship refers to a situation where a person has agreed personally to perform work for an employer under the employer’s direction and supervision in return for pay or some other remuneration. Based on this, the constituent elements of an employment relationship are:

  • employment contract;
  • personal performance of the work;
  • pay or some other remuneration;
  • performance of the work on behalf of the employer; and
  • employer’s direction and supervision.

The scope of the Act excludes work that is not performed for pay, such as leisure activities, positions of trust and voluntary work. Ordinary leisure activities include voluntary coaching of children and young people in sports clubs. 

The definition of employment relationship as determined in the Employment Contracts Act is a peremptory provision. Any agreement by the parties on whether the work is performed subject to an employment contract or not cannot bind the insurance company if the agreement does not comply with the Act. 

A family member of a self-employed person can also work in an employment relationship and be subject to the compulsory insurance even if he or she lives in the same household with the self-employed person. If the constituent elements of an employment relationship are not met, for example if a family member does not receive any pay or other remuneration for the work, the compulsory insurance cover does not apply. A family member who has taken out a self-employed person’s pension insurance policy is entitled to the self-employed person's voluntary working hours insurance cover

Persons working in leading positions

A person who works for pay or other remuneration in a company in a leading position is sometimes not in an employment relationship. However, such persons are always comparable to an employee if they personally own no more than 30 per cent of the company shares or if they together with their family members own no more than 50 per cent of the company share and of this share they personally own no more than 30 per cent. 

In addition to the owned shares, the number of votes generated by the shares is taken into account. In corporations other than limited companies, the equivalent factual powers are considered instead of the company shares.

Person in leading positions means:

  • managing director;
  • member of the Board of Directors; and
  • others who have equivalent positions or equivalent factual powers.

Family member means:

  • spouse;
  • cohabiting partner; and
  • relative in the direct line of descent or ascent of the worker and living in the same household.

Both direct and indirect ownership is taken into account. Indirect ownership is considered if the person alone or together with family members owns more than half of the intermediate company or they have the corresponding control in the same. 

Example:

For more examples of indirect ownership, see the Insurance Handbook. 

A person who works in a leading position and is excluded from the compulsory insurance cover can take out a voluntary insurance policy under TyTAL against accidents if he or she has a self-employed person’s pension insurance (self-employed person’s voluntary working hours insurance). 

Partners of limited partnerships and general partnerships

General partners of a limited partnership and partners of a general partnership are not covered by the compulsory workers’ compensation insurance. Partners who have a compulsory or voluntary self-employed person’s pension insurance can cover themselves against accidents that may happen in self-employed work by taking out the self-employed person’s voluntary working hours insurance.

Modified 16.08.2016