Federal Office of Private Insurance FOPI
Federal Office of Private Insurance FOPI
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Special cases of non-life insurance
Non-life insurance covers risks associated with persons (accident, health), items belonging to the insured person (vehicles, mobile property, real property, goods, etc.), or also assets (liability, legal expenses, financial losses, etc.). A few special cases will be presented here from the perspective of supervision.
Two systems exist in parallel in the world of accident insurance:
- mandatory insurance
- private (or supplemental) insurance
1) Mandatory insurance
The legal basis for mandatory accident insurance is the Federal Law on Accident Insurance (AIL).
Employees are insured against accidents through the Swiss Accident Insurance Fund (SUVA) or other authorized insurers. Article 66 of the AIL specifies which enterprises and administrations must provide their employees with mandatory insurance under SUVA. SUVA is an institution under public law with legal personality. It is not subject to supervision by FOPI.
Individuals not eligible for insurance under SUVA must be insured against accidents by one of the following entities:
- private insurance institutions
- public accident insurance schemes
- health insurance schemes
Private insurance institutions are subject to FOPI supervision, as are health insurance schemes with respect to their supplemental health insurance activities.
2) Private insurance
Freelance and self-employed individuals are covered against accidents in the framework of the Health Insurance Act. But they often supplement this basic coverage through private insurance. Employed individuals may also supplement the benefits of the AIL (for instance, coverage for private hospital rooms).
Individuals not eligible for insurance under SUVA must be insured against accidents by one of the following entities:
- private insurance institutions
- public accident insurance schemes
- health insurance schemes
Private insurance institutions are subject to FOPI supervision, as are health insurance schemes with respect to their supplemental health insurance activities.
2) Private insurance
Freelance and self-employed individuals are covered against accidents in the framework of the Health Insurance Act. But they often supplement this basic coverage through private insurance. Employed individuals may also supplement the benefits of the AIL (for instance, coverage for private hospital rooms).
For buildings, these risks are covered either by the cantonal insurance funds with a monopoly (in 19 cantons and half-cantons), or by private insurance institutions. The latter insure against fire and losses arising from natural events in the following cantons and half-cantons: Appenzell Innerrhoden, Geneva, Obwalden, Schwyz, Ticino, Uri, and Valais. The cantonal insurance funds are not subject to supervision by FOPI, since they are public funds.
In the case of insurance against loss caused by natural events, the scope of the coverage and the rates of the premiums are uniform and mandatory for all private insurance companies. They are determined in the framework of the Swiss pool for the coverage of losses caused by forces of nature. The insurance institution must adopt this rate and add the necessary margins. The rate is subject to approval by FOPI.
In the case of insurance against loss caused by natural events, the scope of the coverage and the rates of the premiums are uniform and mandatory for all private insurance companies. They are determined in the framework of the Swiss pool for the coverage of losses caused by forces of nature. The insurance institution must adopt this rate and add the necessary margins. The rate is subject to approval by FOPI.
For all drivers of motor vehicles, the liability insurance for motor vehicles is mandatory. However according to the principle of freedom of contract, a company is free to decide if it wants to conclude insurance contracts and what these cover. This has led insurers to differentiate premiums according to gender, age, region, and even nationality of the drivers or not to conclude any contract at all according to the same criteria. But this contract autonomy is nevertheless limited; for instance, differentiation according to nationality is only permissible if it does not violate constitutional rights.
According to the Federal Office of Justice (FOJ), differentiation according to nationality could in principle be compatible with article 8, paragraphs 1 and 2 of the Constitution to the extent that the differentiation is objectively based on concrete circumstances. If the rate schedule takes into account the criterion of nationality based primarily on objective claims statistics, the corresponding rates appear to be permissible to the extent that the aforementioned criterion is applied to all the nationalities existing in the pool of society.
According to FOJ, the decision to not conclude contracts with citizens of certain countries may be justified if the contracts with the citizens of the affected countries would entail an actuarial risk that is incalculable and that cannot be absorbed through an appropriate rate schedule. FOPI acknowledges that such a state of affairs is not likely to arise. As a consequence, the nationality of drivers continues to play a role, but not a role that can lead to exclusion.
According to the Federal Office of Justice (FOJ), differentiation according to nationality could in principle be compatible with article 8, paragraphs 1 and 2 of the Constitution to the extent that the differentiation is objectively based on concrete circumstances. If the rate schedule takes into account the criterion of nationality based primarily on objective claims statistics, the corresponding rates appear to be permissible to the extent that the aforementioned criterion is applied to all the nationalities existing in the pool of society.
According to FOJ, the decision to not conclude contracts with citizens of certain countries may be justified if the contracts with the citizens of the affected countries would entail an actuarial risk that is incalculable and that cannot be absorbed through an appropriate rate schedule. FOPI acknowledges that such a state of affairs is not likely to arise. As a consequence, the nationality of drivers continues to play a role, but not a role that can lead to exclusion.
In contrast to the basic insurance, the supplementary health insurance is optional and is subject to private law. The two following types of insurer provide this additional coverage:
- health insurance companies
- private insurers
The “supplementary health insurance” division monitors the private insurers on the one hand which mainly operate this branch of insurance and on the other the health insurance companies in the supplementary health insurance sector. Further information can be found in the “supplementary health insurance” section.
The twenty or so private insurers who provide supplementary health insurance operations together with other sectors, in which this branch is not in the forefront, are supervised by the “non-life insurance“ division.
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