Denial of a Claim by the Health Insurer against a Service Provider

Facts

Dr. [C.], who resides in the canton of Lucerne, operates a practice in the canton of Aargau. According to an agreement dated April 26, 2007, [C.] was obliged to transfer the lump sum of CHF 16,100 to INTRAS Insurance under the title "Reimbursement Claim for the Years 2005-2006" within 30 days. Since the payment was not made, INTRAS health insurance initiated debt collection proceedings. [C.] filed an objection to the payment order. By decision of May 15, 2008, the President of the District Court of Lucerne-City granted INTRAS provisional enforcement for the amount of CHF 16,100.

On August 5, 2008, [C.] filed a denial of claim with the arbitration tribunal pursuant to Art. 89 KVG of the canton of Lucerne and requested that it be determined that he owed nothing to INTRAS, and that the debt collection proceedings initiated on December 22, 2007 be discontinued. By decision of the President dated August 13, 2008, the arbitration tribunal did not enter into the claim and referred the files to the District Court of Lucerne-City for processing.

Considerations

The Federal Court dismisses the appeal. It holds that the arbitration tribunal is materially competent under Art. 89 para. 1 KVG to assess the service provider's denial of claim regarding a claim asserted by the health insurer through debt collection proceedings, even if the agreement exhibits all the characteristics of a novation within the meaning of Art. 116 OR. The legal relationship between the health insurer and the service provider is of a public law nature and cannot be transformed into a private law relationship by an agreement.

Regarding the territorial jurisdiction, the place of jurisdiction under Art. 89 para. 2…