Facts
The case concerns an insured person who demanded that the Compensation Fund of the Canton of Bern and the Administrative Court of the Canton of Bern cover the costs for the restoration of his amalgam fillings through the supplementary benefits. The lower instance had rejected this, as this was not a dental treatment for the preservation of dental function, but rather the treatment of a general illness, which is not covered by the supplementary benefits.
Considerations
The Federal Supreme Court came to a different conclusion. According to the wording of Art. 3d para. 1 let. a LPC and Art. 8 para. 1 OMPC, in principle all dental costs, including the expenses for measures to treat general illnesses, are subject to the reimbursement claim, provided that they are simple, economical and appropriate measures.
The legislative history of Art. 3d LPC as well as the meaning and purpose of the supplementary benefits do not reveal any restriction to dental treatments for the preservation of dental function. Rather, the dental measures necessary for the treatment of a general illness can be assigned to the current basic needs.
Systematically, there is also no general exclusion of certain dental interventions. The list in Art. 3d…