Facts
This case concerns the right to mora interest on arrears of disability insurance benefits paid to an insured person by the insurance company Helsana. The key facts are as follows:
- By decision of 11 November 2003, the insured person B. was granted retroactive daily allowances and pensions for the period from 1 March 1992 to 31 January 1999, paid on 14 November 2003.
- The insured person claimed mora interest of CHF 16,963.75, which the insurance company Helsana refused to pay in its decision of 8 December 2003 and its decision on objection of 9 January 2004.
- The insured person appealed against these decisions to the Cantonal Court of Basel-Country, which upheld the appeal on 19 May 2004 and ordered Helsana to decide again on the right to mora interest.
- Helsana then appealed to the Federal Court against the cantonal decision.
Considerations
The Federal Court examined the question of the right to mora interest in two stages:
For the period up to 31 December 2002: According to the case law prior to the entry into force of the GSSLA, mora interest was only due in exceptional cases, in the presence of abusive or illegal conduct by the administration. In the present case, the initial position of the insurer was not unreasonable, and the delay in the payment of benefits was not excessive. The conditions for the granting of mora interest were therefore not met for this period.
For the period from 1 January 2003: With the entry into force of Art. 26 para. 2 GSSLA, mora interest is due on benefits whose entitlement arose at least 24 months earlier, and this from 1 January 2003.…