This article reviews the trends in the institutional development of work accident and sickness daily allowance schemes. It mainly concentrates on Organization for Economic Co-operation and Development (OECD) countries. It starts by outlining the history of work accident insurance, in most countries, the first social insurance programme legislated; its history highlights a number of factors behind the development of later programmes. The article then describes sickness insurance. Again, it begins with historical developments, focusing, in particular, on the universalism and generosity of benefits. It then moves on to discuss the extent to which sickness benefits have, in recent years, been targets for retrenchment. It finally tentatively reports future trajectories of these two income maintenance programmes. The evolution of work accident and sickness insurance schemes shows how insurance must be changed when the social problems for which the programme originally provided protection change in character.