Facts
D., a member of Konkordia, Swiss Health and Accident Insurance, did not agree with the transfer from her private patient insurance PPV to the insurance department Diversa plus as of January 1, 1996. She considered the previous scope of insurance coverage to no longer be guaranteed and filed a complaint with the Administrative Court of the Canton of Lucerne.
The Administrative Court accepted the complaint, as Konkordia had continued its Diversa plus insurance according to the previous law until December 31, 1996. However, the court dismissed the complaint, as the additional benefits desired by the insured could only be insured additionally by a private insurer.
The insured filed an administrative court appeal against this decision with the Federal Insurance Court. She claimed that the transfer to the insurance department Diversa plus represented a restriction of insurance coverage and that she was entitled to the preservation of existing benefits.
Considerations
The Federal Insurance Court states that disputes over the scope of supplementary insurance to be offered for the preservation of existing benefits are of a private law nature and are to be assessed in accordance with Art. 47 of the Federal Law on the Supervision of Insurance Companies (VAG).
Since Konkordia made the adjustment of the insurance relationships in two stages, both the change from the private patient insurance PPV to the Diversa plus department and the subsequent change to supplementary insurance in accordance with the Insurance Contract Act (VVG) must be examined…