Accidents involving foreign guests are expensive for municipalities

Density stress in the air - the report from the base jumper scene

Switzerland is a mecca for high-risk sports. If foreign guests leave without having paid rescue and hospital costs, in the worst-case scenario the costs are borne by municipalities.

Lauterbrunnen in canton Bern attracts base jumpers from all over the world – around 70 have had fatal accidents to date. Serious accidents also regularly occur in mountain sports, bungee jumping, canyoning and downhill mountain biking in other regions.

These are expensive: the average bill for an Air-Glaciers rescue mission is CHF3,600 ($4,522) but can reach CHF5,000 or more for complex rescues. A long hospital stay is even more costly.

Uncovered costs

Guests from third countries in particular are not always sufficiently insured. If they go abroad after a rescue or treatment without having paid the bills, hospitals, rescue services or cantons and municipalities are sometimes left with the costs.

A little over ten years ago, the village of Alpthal in canton Schwyz, with a population of 600, had to pay a hospital bill of more than CHF100,000 because a destitute foreign pilgrim on the Way of St James fell on municipal soil.

Who is stuck with which costs?

The Air-Glaciers rescue service has to write off an average of CHF150,000 ($188,415) per year as bad debt losses because amounts due cannot be collected despite all efforts.

The Air Zermatt rescue service is stuck with rescue costs of over CHF100,000 every year, even though it also calls in specialised debt collection agencies. In certain cases, it can take several years for a case to be finalised.

In the municipality of Meiringen in canton Bern, there are occasional cases in which inpatient emergency medical treatment remains unpaid. However, the costs can be cushioned via the equalisation of burdens.

The Bernese municipalities of Lauterbrunnen, Interlaken and Wilderswil and the Valais municipalities of Zermatt and Saas-Fee have not had to cover any costs in recent years.

The municipality of Flims in canton Graubünden has to pay between CHF2,000 and CHF5,000 every few years and often remains stuck with these costs because collection abroad is costly and often futile.

The municipality of St Moritz only covers the costs if the outstanding debts cannot be covered by any other body and collection from the person concerned has been unsuccessful. In 2024, these costs amounted to around CHF17,500.

The municipality of Engelberg in canton Obwalden is usually left with small amounts, between CHF2,000 and CHF4,000 per year. However, there has also been one year with several hundreds of thousands of francs.

If the treatment was necessary for survival, the hospital can pass the bill on to the public purse. The law provides for this: if a tourist requires immediate assistance, the canton of residence must pay the rescue or hospital costs.

Some cantons – such as Uri and Nidwalden – fulfil this obligation directly, while others pass the costs on to municipalities. In canton Bern, the canton and all municipalities bear the costs jointly via the equalisation of burdens, so that tourist resorts are not excessively penalised.

What is considered a place of residence?

If the tourist has booked a three-week holiday in a hotel in Lucerne, then this location is decisive, even if the accident happened on a day trip to the Ballenberg Museum in canton Bern. If the tourist is merely travelling through, i.e. has no clear “place of stay”, then the place of the accident is decisive.

It is therefore no coincidence that, when asked by Swiss public television, SRF, it is mainly Bernese municipalities that say they do not incur any uncovered costs as a result of high-risk sports accidents.

‘Anything but community-friendly’

The situation is worse in other holiday regions. “This law is anything but community-friendly, especially as it doesn’t just cover high-risk accidents,” says Martin Kuratli from the municipality of Flims in canton Graubünden. His municipality finds itself in this situation every few years.

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Compared with the past, however, the situation has improved. “The majority of guests are better insured,” says Kuratli. It would be even better if hospitals could block the estimated costs on a patient’s credit card before treatment, as is already common practice abroad. “It’s difficult to understand why this shouldn’t be possible across the board here.”

Ordinary accidents carry more weight

The municipality of Engelberg in canton Obwalden also repeatedly faces costs that cannot be recovered. According to municipal clerk Roman Schleiss, however, this has only affected one high-risk sport (freeriding) in the past ten years. “In most cases, it’s about ordinary accidents or health problems.”

Hopefully this base jumper is well insured: A base jumper plunges down the mountain near Mürren in the Bernese Oberland. KEYSTONE/Anthony Anex

According to Schleiss, how much the municipality has to pay varies greatly from year to year. It is usually small amounts, between CHF2,000 and CHF4,000 per year. “But we’ve also had a year with bills in the hundreds of thousands.” Fortunately, this is rare.

It is also encouraging that most high-risk athletes are well insured. “We are hardly ever left with any costs,” says Schleiss. And anyway: “The income from tourism far exceeds these costs.” The bottom line is that being a mecca for foreign guests pays off for municipalities.

Translated from German using DeepL/amva/ts