Facts
On September 23, 1999, the SWICA Health Organization filed a lawsuit against the Herz-Klinik Bodensee am Weinberg AG for the reimbursement of CHF 98,372.55 plus interest for treatment costs paid in 1996 and 1997. The Administrative Court of the Canton of Thurgau dismissed the claim on November 1, 2000. The plaintiff filed an appeal with the Federal Supreme Court on February 5, 2001.
Considerations
The Federal Supreme Court dismisses the appeal. It finds that this is a civil dispute of a pecuniary nature, to which the provisions of the Insurance Supervision Act (VAG) do not apply. The plaintiff cannot derive its claim for reimbursement from an insurance contract or from the tariff agreement concluded between the defendant and the Cantonal Association of Health Insurance Funds in Thurgau. Rather, the claim, if any, must be qualified as a claim for unjust enrichment. However, since the plaintiff has paid the invoices without reservation, the claim is time-barred.
The Federal Supreme Court explains that a claim for unjust enrichment and a contractual claim are mutually exclusive. As long as a claim can be asserted on the basis of a contract, the law of unjust enrichment does not apply. Since the plaintiff has paid the invoices without reservation, it can no…