Facts
The applicant, born in 1947, is insured with SWICA Gesundheitsorganisation (SWICA). In 2000, a dentist diagnosed him with congenital micrognathia and prognathism, classified as congenital malformation No. 210 in the Annex to the Ordinance on Congenital Infirmities (ConDisO). The dentist recommended implant-supported prosthetic treatment. The applicant requested SWICA to cover the costs, but SWICA refused, stating that the conditions for coverage by the mandatory health insurance were not met. The cantonal court dismissed the applicant's appeal.Considerations
Even though the applicant did indeed suffer from a congenital malformation of the type of congenital lower prognathism within the meaning of Art. 19a para. 2 no. 22 HIBO, the dental treatment recommended at the age of 53 cannot be considered "necessary after the 20th birthday due to a congenital infirmity" within the meaning of Art. 19a para. 1 let. a HIBO. This provision aims to ensure that the treatment of congenital malformations of the jaw and face can be planned and carried out in such a way that it is completed before the 20th birthday, i.e., before the end of coverage by disability…