Claim for Supplementary Insurance to Health Insurance under the KVG

Facts

D. was insured with the X. Insurance, among other things through a private patient insurance (PPV), until the end of 1995. At the time of the entry into force of the Federal Law on Health Insurance (KVG) on January 1, 1996, the X. Insurance transferred D. to the "Nova" insurance. D. was of the opinion that the X. Insurance had thereby violated the guarantee of existing contracts pursuant to Art. 102 para. 2 KVG, according to which health insurance funds are obliged to offer their insured persons insurance contracts that provide at least the same scope of insurance coverage as before.

D. initially filed an administrative court appeal with the Administrative Court of the Canton of Lucerne, which was dismissed. Subsequently, D. sued the X. Insurance with the Social Insurance Court of the Canton of Zurich pursuant to Art. 47 para. 2 VAG, in order to obtain an insurance contract that provides at least the same scope of insurance coverage as before.

The Social Insurance Court did not enter into the claim. Against this, D. filed an appeal with the Federal Supreme Court.

Considerations

The Federal Supreme Court first examined whether there was a civil law dispute that was subject to appeal. It concluded that the dispute over the minimum content of the supplementary insurance offered to the plaintiff is of a private law nature, as supplementary health insurance under the new KVG law is subject to private law.

Pursuant to Art. 47 para. 1 VAG, the judge decides on private law…