Insured's Participation in the Costs for the Early Replacement of an Aid

Facts

In this case, the question was whether the insured can be required to participate in the costs for the early replacement of a hearing aid if it has become unusable due to a serious breach of the duty of care. The IV-Stelle (IV Office) of the Canton of St. Gallen had obliged the insured to participate in the costs, which was confirmed by the Versicherungsgericht (Insurance Court) of the Canton of St. Gallen. The insured then filed an administrative court appeal with the Federal Supreme Court.

Considerations

The Federal Supreme Court concluded that Art. 21 para. 4 of the Federal Act on the General Part of Social Insurance Law (ATSG) constitutes the legal basis for Art. 6 para. 2 of the Ordinance on Aids of the Disability Insurance (HVI). This provision allows the insured to be required to participate in the costs if an aid becomes unusable prematurely due to a serious breach of the duty of care.

The Federal Supreme Court further stated that grossly negligent conduct of the insured is sufficient to justify cost participation. In the present case, the leaving of the hearing aid lying around openly was considered a serious breach of the duty…