Facts
The young Peter Gafner, born on September 19, 1980, suffered from left-sided cryptorchidism (congenital disability no. 355 on the list of congenital disabilities) and a right-sided inguinal hernia. These two anomalies were treated on March 2, 1982 by a single operation, including a herniotomy and an orchidopexy. The compensation fund of the canton of Bern refused to cover the costs of the operation, considering that it was mainly aimed at treating the inguinal hernia, which is no longer on the list of congenital disabilities. The insurance court of the canton of Bern annulled this decision and ordered the disability insurance to cover the costs of the orchidopexy, considering that the disability insurance had to cover the treatment costs of the cryptorchidism, even if it had been treated at the same time as the inguinal hernia.Considerations
The Federal Insurance Court considers that when two conditions falling under different insurance domains (here the cryptorchidism, covered by disability insurance, and the inguinal hernia, falling under health insurance) are treated simultaneously by a single medically indicated operation for each of the conditions and without incurring additional costs, the disability insurance must cover the full costs.…