Facts
The appellant, Insurance [A. AG] , and the respondent, [B.] , were parties to a lawsuit concerning the obligation to perform under a supplementary insurance policy for social health insurance. The respondent was employed by [C. AG] from 1 April 2009 and was insured for daily sickness benefits under a group insurance policy with Insurance [A. AG] . After the respondent fell ill on 6 September 2010, the insurance company paid the insured daily benefits. The employment relationship between the respondent and [C. AG] was terminated as of 28 February 2011. The insurance company commissioned Dr. med. [E.] to conduct a medical examination to assess the respondent's ability to work, which did not reveal any diagnosis affecting the ability to work and did not assume any impairment of the ability to work from a psychiatric point of view.
The respondent filed a lawsuit with the Insurance Court of the Canton of St. Gallen and requested that the insurance company be ordered to pay her CHF 20,181.50 plus interest at 5% since 17 January 2013. The Insurance Court granted the lawsuit and ordered the insurance company to pay the respondent CHF 20,181.50 plus default interest at 5% since 17 January 2013.
Considerations
The Federal Court had to decide whether the obligation to perform under the supplementary insurance policy for social health insurance existed. The appellant assumed that there was no incapacity for work during the period in question, while the lower court found that the respondent should be granted a transition period of around five months to switch to an adapted professional activity.
The appellant complained that the lower court had not applied the case law on overcoming obstacles in cases of somatoform pain disorders. However, the Federal Court decided that the question of the applicability of the case law according to BGE 130 V 352 was not decisive…