Health insurance ombudsman’s office records more cases
Published: Friday, May 17th 2024, 17:01
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The health insurance ombudsman's office recorded a significant increase in inquiries from insured persons in Switzerland last year. In 2023, the ombudsman's office mediated 370 more cases than in the previous year. This was largely due to the premium increases, according to the annual report published on Friday.
Inquiries and advice on insurance benefits made up the majority of the 4560 cases handled by the ombudsman's office, accounting for 47.1% of the total, the report continued. With 29.7 percent of cases, the area of "taking out insurance" - which also includes changing insurance - was in second place.
This was followed by the "contributions" area with a share of 15.9%, which also includes inquiries about premiums and cost sharing. Compared to 2022, 247 additional cases were recorded here. There was also the "Other" area, which includes questions relating to premium reductions or data protection.
More than half of all cases last year related exclusively to inquiries about basic insurance, the report continues. Here, the ombudsman's office recorded an increase of 561 cases compared to 2022.
Insured persons increasingly overwhelmed
The ombudsman's office is "increasingly confronted with complex cases with an international dimension", the statement continued. In addition, more and more people are turning to the ombudsman's office every year who are overwhelmed by insurance matters - whether for health or age-related reasons.
In 3694 cases - i.e. 81% of all inquiries - the ombudsman's office was able to clarify the questions of insured persons in 2023, the same number of cases as in the previous year. In 419 cases, the ombudsman's office requested that the health insurer review the decision disputed by the insured person - and was successful in 345 cases. In 2022, 200 reviews were requested.
The health insurance ombudsman's office under private law mediates between insured persons and health insurers.
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