Facts
Concordia Swiss Health and Accident Insurance had imposed a deferral of benefits on its insured person K. until the Social Services of the City of X. had paid the debt collection costs that had arisen in connection with the fruitless debt collection of premium claims. The City of X. filed a denial of justice complaint against the inaction of the health insurer without being authorised by the insured. The Federal Court had to decide whether the lower court was right to enter into this complaint and to oblige Concordia to issue a contestable ruling towards the Social Services of the City of X.Considerations
The Federal Court affirmed the legitimacy of the City of X. to file the denial of justice complaint. While the merely indirect financial interest of the social welfare authority in the provision of benefits by the health insurance is generally not sufficient for the legitimacy to file a complaint, in the present case the City of X. has a legitimate interest in the issuance of a contestable ruling based on the specific federal law provisions on premium collection and the consequences of payment default. Health insurers are obliged to report the…