Facts
[A.], born in 1959, was compulsorily insured for basic health care with CSS Insurance AG (CSS). By letter dated November 23, 2014, he terminated the insurance relationship as of the end of 2014, indicating that he would notify the new insurer by mid-December 2014 at the latest. CSS confirmed the termination in writing on November 29, 2014, with the note that it could only become legally effective if there were no outstanding amounts (premiums, cost sharing, default interest, and debt collection costs) by the end of the notice period and the confirmation of acceptance from the new health insurer was provided. As [A.] did not submit the confirmation of acceptance, CSS continued to consider him insured with it and demanded premiums for January to August 2015. [A.] thereupon filed a legal objection to the payment order. The Federal Supreme Court partially upheld the subsequent appeal and referred the matter back to the lower court to review CSS's liability for damages.Considerations
The Federal Supreme Court concluded that the "full" settlement of all outstanding amounts required for a change of insurer under Art. 64a(6) of the Health Insurance Act (KVG) refers to the total amount of the claim recorded in a certificate of loss, even if the canton has taken over 85% of the amount in accordance with Art. 64a(3) and (4) KVG. This is based on the following considerations:
First, the wording of the provision requires "full" payment, without any differentiation between the portion taken over by the canton and the portion to be borne by the insured. The…