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| Hi rjhatch,
Did you solve this problem yet? Can I ask how it was resolved?
We are having a similar issue, my boyfriend sent a mail to Progres (then Aerosana) before the end of November 2010, to cancel his insurance with them, and he also changed to CSS. We got a confirmation from Progres that his coverage was indeed canceled. However, we recently received a bill in the mail for almost 2000CHF from Progres claiming that since they did not recieve confirmation from CSS that he was actually insured, by law they had to continue to cover him and have now charged him for coverage since January.
This is insane, how are we liable to pay for insurance that we have properly canceled ?
Please let me know if you or anyone has advice about how to deal with this situation. Thank you!! | |
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From a legal standpoint, the situation is actually quite clear:
Article 7 section 5 of the federal on health insurance states the following:
Your boyfriend’s contract with the old insurer ends only at the point in time when the new insurer has given notice to the old insurer that he is covered by them.
Meaning: Your boyfriend is, as of now, still insured with Progrès (Aerosana).
If the new insurer (CSS) did not give such notice, they are liable for any damages caused by their omission, especially differences in the premiums (that your boyfriend has to pay to Progrès, as he is still insured by them for the time being, see above).
Meaning: He is, basically, still insured with Progrès and he will have to pay their premiums but the difference between the two premiums will have to be reimbursed by CSS.
As soon as the old insurer (Progrès) gets the notice, they will have to inform your boyfriend, telling him when his change to CSS takes effect.
In the light of the above, I would suggest the following course of action (if your boyfriend does not have an insurance broker, otherwise the broker will know what to do):
Talk to CSS. If they insist that they did send the notice, tell them to sort it out directly with Progrès. Do not forget to ask them about the date the notice was sent, as you need this information later on.
Call Progrès nontheless (writing is even better) and tell them that CSS insist that the notice was given (at the date provided by CSS) and that your boyfriend is therefore insured by CSS.
That would be the easy solution.
If they forgot to send the notice, tell them to do it now and ask them how they will refund the difference between the two premiums. Try to get this in writing. Tell them to sort out the rest with Progrès.
In this case, your boyfriend will have to pay the premiums to Progrès. You should then contact CSS again to fix the details for the refund.
If none of this works, contact the Ombudsmann (link provided in Ittigen's post).
Disclaimer: I am quite knowledgeable in the field of health insurance law. However, I not a lawyer and English is not my mother tongue.