How can policyholders ensure that their supplementary insurance offers the best cover for their personal needs? By knowing your rights and checking your contract documentation, you can avoid unpleasant surprises.
Choose the right product
Before you take out supplementary health insurance, check carefully whether the offer meets your needs. It is important to read the general terms and conditions of insurance (T&Cs) and the supplementary terms and conditions. Insurers may stipulate in the T&Cs that certain details – such as which clinics, therapists or treatment methods are covered – are included in separate lists. These can be adjusted unilaterally by the insurer as long as the core of the insurance cover is retained.
Check what costs are covered
Insurers cover different costs depending on the doctor or clinic. If there is no contract with the service provider, the insurer will inform you of the maximum amounts it will pay or refuse to cover the costs altogether. Before treatment, clarify which costs are covered and request a confirmation of coverage from the insurer.
Note the cancellation date
Since the revision of the Insurance Contract Act, policyholders can cancel their contract in writing after three years with three months’ notice to the end of the insurance year, even if a longer term was originally agreed. Other individual agreements are possible. The insurance year in private insurance does not necessarily end on 31 December. Your contract documentation is decisive in this regard.
Check your invoices carefully
Always check your invoices carefully. Were the invoiced services actually provided in full? In the event of discrepancies, it is worth making enquiries, which may then lead to errors being corrected and excessive charges being avoided.
Change insurer
Would you like to take out supplementary health insurance with another insurer? Please wait until the desired insurance company has confirmed your supplementary health insurance. Only then should you cancel your existing insurance. In this way, you do not run the risk of not having cover during the changeover.
If there is any confusion, the first point of contact is always your supplementary health insurer. If your attempt to resolve the matter does not lead to a satisfactory solution, you can contact the ombudsman’s office. If you suspect a violation, report the matter to FINMA. It checks such reports carefully and intervenes where necessary.
Read the first part of this series to find out how FINMA’s supervision protects supplementary insurance policyholders.
