Facts
The facts of the case are as follows: the companies KVD AG and CMAR SA were founded on June 22, 2001, with the purpose of managing social health insurance according to the principle of reciprocity. The two companies applied for recognition as a health insurance fund and authorization to practice social health insurance as of January 1, 2002. The Federal Department of the Interior rejected their application due to their administrative, financial, and personal dependence on companies of the Helsana group, as well as the risk of risk selection.
The companies appealed against this decision, alleging a violation of their right to be heard and contesting the reasons for the refusal. The Federal Insurance Court was seized of the case.
Considerations
The right to be heard
The Federal Insurance Court examined whether the companies had been sufficiently informed of the reasons for the refusal of their application. It considered that the companies had been aware of the problems related to their dependence on the Helsana group and the risk of risk selection, but that the Federal Department of the Interior had not sufficiently motivated its decision.
Recognition as a health insurance fund and authorization to practice social health insurance
The Federal Insurance Court examined the conditions for recognition as a health insurance fund and authorization to practice social health insurance. It considered that the companies met the formal conditions, but that the Federal Department of the Interior had rejected their application due to their dependence on the Helsana group and the risk of…