In what situation can I claim?
The system for compulsory health insurance covers risks regarding the inability to work, while the risk of disability or death of the insured person is covered by the compulsory pension and disability insurance system.
Occupational injuries are all injuries which occur as a result of work or whilst carrying out work.
Occupational diseases are defined in the Rules concerning the list of occupational diseases.
What conditions do I need to meet?
Other persons who are not included in compulsory or voluntary health insurance and who perform work or activities are included in insurance in the case of occupational injury or occupational diseases.
For these persons contributions for individual cases of insurance in flat-rate sums or particular pension contribution rates are paid in accordance with the decision determining the contributions for special insurance cases.
The period for such insurance is not counted in the insurance period.
Persons included in particular cases of insurance are insured in the case where occupational injury or occupational diseases occur during performance of particular work or activities outside of compulsory insurance, in which case they are entitled to a disability pension, or, in the case of death, surviving family members obtain the right to a widow's or survivor's pension if assessed for a pension to which the insured person would be entitled on death in the case of compulsory insurance.
What am I entitled to and how can I claim?
In the case of occupational injury or occupational disease the insured person is entitled to the cost of all essential treatment and medical rehabilitation from the compulsory health insurance system.
Temporary inability to work
Compensation in the case of illness is paid by the employee for the first 30 days and then by ZZZS. The right to compensation lasts until the ability to work returns. In the case where the insured person leaves employment during the period of being unable to work, the insured person is entitled to 30 further days of compensation for inability to work on terminating employment.
In the case of disability the insured person is entitled to a disability pension and various disability compensations.
If disability is the result of occupational injury or occupational disease, the disability pension shall be calculated at 57.25% of the pension base. If it is more beneficial to the insured person, the disability pension may be assessed according to completed retirement age.
In the case of death of the insured person, surviving family members are entitled to a widow's or survivor's pension upon fulfilling the required conditions.
- ZPIZ - Pension and Disability Insurance Institute of the Republic of Slovenia
- ZZZS - Health Insurance Institute of Slovenia
Know your rights
The links below listing your rights are not European Commission pages and do not represent the view of the Commission:
European Commission publications and web pages:
Who do you need to contact?
Rights to health insurance are assessed through a chosen general physician or other physician in the case of urgent assistance.
Requests for assessment in the case of disability or death of the insured person must be submitted to the ZPIZ regional unit.