Facts
The dispute concerns the question of whether the insured fulfilled their obligation to mitigate damages by reporting to the Disability Insurance (DI) on 7 December 2000 for vocational reintegration measures. The health insurer Helsana interrupted the payment of daily sickness benefits as of 31 March 2001, inviting the insured to turn to the DI for possible waiting allowances.
The insured repeatedly requested waiting allowances from the DI, but their request was rejected on the grounds that the reintegration measures were not yet concretely planned. The DI indicated that it first had to carry out preliminary clarifications.
Considerations
The Federal Supreme Court considers that the insured cannot evade their obligation to mitigate damages towards the health insurer by invoking the fact that they are awaiting measures from the DI. Indeed, as soon as a request has been filed with the DI and vocational reintegration measures are seriously considered, the insured is entitled to waiting allowances from the DI, and no longer to daily allowances from the health insurance fund.
In the present case, although the insured's request for waiting allowances was rejected by the DI, they…