You have a problem with your insurance company

Here you can find answers to frequently asked questions and information on how to deal with problems with your insurance company. FINMA will review your tip-offs regarding possible irregularities. Where there is concrete evidence that financial market laws have been violated, FINMA carries out further investigations and imposes measures on the supervised institution if necessary.

Have you already talked to the insurance company?

Many problems can be resolved by talking directly to your insurance company – although we recommend going straight to management.

Do you want to tell FINMA about your problem?

In that case, please outline the facts clearly and transparently in writing. If possible, use our report form and attach copies of all relevant policies. If the insurance company has already sent you a letter setting out its position, please attach that too.

What support can I expect from FINMA?

FINMA has an obligation under the Insurance Supervision Act to protect policyholders from any misconduct on the part of their insurance provider. Civil law disputes between insurance companies and policyholders, on the other hand, are a matter for the courts.

It is not always easy to decide what constitutes a civil law dispute and what looks like a case of abuse. Abuse means that policyholders or beneficiaries are repeatedly disadvantaged or that a lot of clients are potentially affected. A substantial difference in treatment also constitutes abuse if the insurance company does not issue a legal or actuarial justification for it.

If FINMA suspects there has been an abuse, it will seek clarification. If the abuse is confirmed, FINMA will then take action against it.

Will I be told the result of FINMA’s investigations?

No. Personal questions or complaints do not entitle you to the disclosure of FINMA’s investigations. A complaint to the regulator is not formally a legal procedure and it does not grant you the right to be a party to any proceedings. In matters like this, we are bound by the Administrative Procedure Act.

Why would FINMA be interested in my case?

FINMA has a duty to act against abuse in the insurance sector. Your information could be helpful.

Who will support me in a civil law dispute with my insurer?

Policyholders can consult the following ombudsmen over civil law disputes:

  • For problems with your basic or supplementary health insurer, contact the Ombudsman for Health Insurance (in German, French and Italian)

  • For disputes related to supplementary health insurance, the Civil Procedure Code provides for simplified court proceedings. While no legal costs are incurred for arbitration and resolution proceedings, they are incurred for frivolous or vexatious litigation, which may also involve costs for the parties concerned.

  • Private insurers in Switzerland, including Suva, have set up a foundation to provide ombudsman services for this sector. If your insurance company is affiliated, you can contact this Ombudsman for Private Insurance.

Can I expect help from FINMA if I have a problem with my life insurer?

FINMA has a statutory obligation, if so requested by a client, to verify the conversion and surrender values quoted by the insurance company. There is no charge for this service. The check shows whether these amounts were correctly determined using a method approved by FINMA.

Before that can happen, the policyholder must have sent a conversion or surrender request to the insurance company. FINMA can only check the figures once the surrender application has been processed. We will not assess whether you have been offered a fair share of the surplus or whether the costs are appropriate. These are matters of civil law and can only be resolved by a court.

What will happen to my benefits if my insurer is insolvent?

If an insurer files for bankruptcy, the proceeds from realising its tied assets will first of all be used to meet claims resulting from insurance contracts. In other words, the entitlements of policyholders take precedence over all other creditors. The tied assets set aside to cover those entitlements have to meet strict legal requirements with regard to risk distribution, risk management and asset category.