All health insurance companies in Switzerland are legally obliged to provide information. If an insurer refuses to cover the costs of a specific benefit, for example, the insured can request a written decision.
The written decision is an official statement provided by the health insurance company. It explains why the costs are not covered for a specific benefit. The insured has the right to request a written decision from the health insurance company.
What does a written decision contain?
A written decision must state the reasons for the refusal to cover costs and must provide an explanation of the insured’s rights of appeal.
What can I do if I don’t agree with the health insurer’s written decision?
The first step would be to contact the ombudsman for health insurance. A simple consultation is free of charge. You also have the option of appealing the decision and subsequently filing an appeal with the insurance court.