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Old 28.04.2011, 14:56
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Changing Health Insurance Problem

hello,

at the end of 2010, I made a decision to change my health insurance from Progres(one of the most expensive basic plans in Geneve) to CSS. I worked with an agent who helped me get all he paperwork done etc. I am signed up and have been using CSS, who are very responsive and helpful. Progres, however, continues to send me monthly bills. After many calls, documents etc..I finally I got a letter last week telling me I was not allowed to change insurance as I had been late on a monthly payment, apparantly somewhere in the tiny print it says I am not allowed to cancel if this is the case.

Am I now forced to have two basic medical insurances for the next year!! its somewhere in the range of 800chf total per month! what can I do. Do I have not rights at all as a consumer???
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  #2  
Old 28.04.2011, 16:15
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Re: Changing Health Insurance Problem

You need to scratch around and find out if they can do that to you.

Then look at this https://secure.om-kv.ch/
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Old 28.04.2011, 16:58
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Re: Changing Health Insurance Problem

One of the companies has gone wrong here. It really shouldn't be possible to have 2 policies. Either the new company did not check your policy status correctly and should not have opened your new Policy or the old company has not shut your policy properly. Either way you may have contributed to confusion somehow but I do not believe you can be liable for 2 policies. Continue in dialog with both companies work out what went wrong and seek a refund from the other. In practises you should receive a refund no problem and not need to keep paying. In theory may take a little time and be a bit painful.
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Old 28.04.2011, 17:48
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Re: Changing Health Insurance Problem

Did you send the notice to quit your insurance by certified mail?

This is your only proof that you actually gave your notice on time.
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Old 01.06.2011, 14:47
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Re: Changing Health Insurance Problem

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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Old 03.06.2011, 09:10
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Re: Changing Health Insurance Problem

Ah the wonders of Swiss health insurance, a veritable minefield.
First of all, it is not possible to be insured for basic insurance by two companies, so you should get a refund from one of them.
Do you have the receipt of your registered letter to progres. Keep that very handy.
It sounds like you have done everything by the book and it is actually the responsibility of CSS to inform your old insurer (progres/aerosana) that you are now insured with them.
I would take it up with CSS.
To the original thread started, you cannot change insurance if you have debts with the old one, but you are now in a sticky situation, best to consult your insurance broker and they should sort it out.
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Old 03.06.2011, 10:44
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Re: Changing Health Insurance Problem

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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!!
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.
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Old 04.06.2011, 10:45
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Re: Changing Health Insurance Problem

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From a legal standpoint, the situation is actually quite clear:

Lots of useful info........
As Sam said!

Don't worry too much. You will only be liable for one payment of insurance with 1 company not for 2 payments with 2 companies. You are forced to have health insurance though so if your new company did not send the notice correctly you should still be covered by the old policy. Maybe you're just stuck with a company you wanted to leave initially.

(Thinking of this in nice way it meant that at least you were always covered with health insurance during this period where the administration of one of the companies was poor - which is the idea of how the system works I guess.).
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Old 20.06.2011, 17:49
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Re: Changing Health Insurance Problem

Thanks very much Sam. So my next question is when I took the new insurance I ticked the box on the form that said I would quit myself (Ich übernehme die Kündigung selber) as there was not enough time for them to do it (they required 10 days) before the cut off the end of November due to their stuffing around. It didn't say anywhere I had to inform the old insurer of the new insurer. So old insurance says I have to pay them and new insurance says I have to pay them.
I talked to the Ombundamn and they said :

The primes of the obligatory health insurance can or must be paid to only one insurance. A double insurance thus is impossible.

and quoted Art. 7 Wechsel des Versicherers, Section 5 as you mentioned above.

But that doesn't help me know who I have to pay (hopefully not both!)
Any more ideas?
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Old 04.07.2011, 12:54
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Re: Changing Health Insurance Problem

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So, we changed health insurance this year. I took the Kundigen forms (provided by the new health insurer) to my old insurer in November last year and they stamped them etc so I thought all was sorted. We then went overseas in December only to return in April to a pile of bills from my old insurer, demanding proof that we had new Basic insurance. I took this proof in to them the week we returned and was told we would receive no more bills. Hahaha.

I have now been informed by my old insurer that I have to pay up until the time I showed them the proof of new insurance, so Jan-April and that my new insurer should reimburse what we have already paid them for this time. Of course my new insurer says they won't do this. So am I really stuck having to pay for both? Any ideas where to next?

When I originally went in with the quitting forms they didn't say anything about providing proof of new insurance.

Quick update:
After talking to the Ombudaman I contacted my new insurer and told them I wouldn't pay them any more until they sorted it out with my old insurer. This finally did the trick and they said that they would look in to it.
So it turns out new insurers DID inform old insurers in Dec last year. Old insurers even replied to them querying it. All of this was on record at new insurers and must have been at old insurers, even though they denied any knowledge to me.

As of today, I have been told I don't owe any more to old insurers but I am still receiving bills from them for all sorts of random amounts. I really don't know why they are having so much trouble with this. I am starting to wonder if they just keep sending bills in the hope that maybe whoever gets them will pay them without realising they don't have to.
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Old 05.07.2011, 00:06
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Re: Changing Health Insurance Problem

Thanks for the update.

Hope the end which seems to be in sight doesn't take to long to come along!.

Keep records of everything you can to help any company that needs further persuasion - bet you have it covered anyway.
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