Federal Office of Private Insurance FOPI
Federal Office of Private Insurance FOPI
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FOPI News no. 1
FOPI News no. 1 of 1st March 2006 - decision of the Federal Supreme Court. Use of cantonal contributions for intercantonal in-patient treatment of patients with semi-private and private insurance in 2001.
The Federal Tribunal sustains the position of the Federal Office of Private Insurance regarding the distribution of basic contributions of supplementary insurance policyholders.
In line with the decision of the Federal Insurance Court at the end of 2001, the cantons must not only subsidise the hospital stay of those patients with basic insurance, but also of patients with semi-private and private insurance. In an agreement with santésuisse, the cantons have made a commitment to pay a lump sum of CHF 250 million for 2001 to the insurance institutions, which the latter will in turn forward to the entitled insured persons. The Federal Office for Private Insurance (FOPI) had to rule on the distribution plans of the insurance institutions concerned. The FOPI rejected several plans, which made provisions to increase the technical reserves using the basic contributions. It also rejected the plans of a health insurer, which wanted to pay out CHF 3.5 million out of a total of CHF 14.3 million and use the difference of CHF 10.8 million to avoid a tariff increase and to build up technical reserves. The insurer appealed against the rejection of its pay out plans taking it to the Federal Supreme Court. The latter has now come down in favour of FOPI and forced the insurer to pay out the CHF 14.3 million. The Federal Supreme Court judged that the use of the basic contributions, as the insurer concerned had envisaged, infringed upon the purpose for which they had been earmarked, because in all probability they would not have benefited to any larger degree the insured parties (in 2001) for whom they had been intended.
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