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Old 01.02.2020, 07:46
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Re: Insurance Runaround

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Hi All, Sorry in advance for the long story. I need help and am not exactly certain where to turn. Hoping someone here can shed some light on my predicament.

I met a lovely Swiss woman in the States. After a year of back-and-forth I decided "Enough!" and got married to her in Switzerland. At about the same time we married I was granted a Swiss B-Visa. I received the Visa in September 2017.

Part of the process of receiving the visa required that I answer a list of questions at the village Gemeinde (municipal office). One of those questions was "Do you have health insurance?"... to which I answered "Yes" because I did in fact have health insurance.

The village official who collected this paperwork never asked me to provide any proof of that insurance, and I never thought to ask if she needed it.

Fast forward to mid-2019. I've decided that since I'm now living almost exclusively in Switzerland that I should just sign up for a Swiss health insurance plan. My U.S. coverage was still in current at the time.

Soon after my application for Swiss health insurance was approved we received a nasty-gram from a cantonal office saying that since I didn't have health insurance (not true) since my B-Visa was approved that I was in violation of the rules that make health insurance compulsory in Switzerland that I was subject to a penalty of several thousand Swiss Franc.

This only happened because the local Gemeinde administrator failed to collect proof of my existing U.S. insurance and then forward that proof along to a cantonal office that oversees insurance compliance.

My wife and I have gone back-and-forth with the Gemeinde, the cantonal office, and with the health insurer to resolve the fact that I did have coverage during the time they say I didn't, but we hit road-blocks at every turn.

We hired a lawyer to pursue this, but to the best of my knowledge he's just retracing steps that I've already taken. He seems as lost in this as I am.

Does anyone have any experience with this? Recommendations for who might help finally get this resolved. I'm not anxious to pay out several thousand Franc because a clerical omission.
He asked whether you had insurance. Did he ask whether you had Swiss insurance?And did you say you had US insurance? Obviously not otherwise he would have said you need Swiss insurance.
"we received a nasty-gram from a cantonal office saying that since I didn't have health insurance (not true) ".

But it is true. You did not have Swiss insurance! You got Swiss insurance in 2019!!!

Seems like a big confusion there and your Swiss wife should maybe have know better.

I think its unlikely you would ever have to pay such a large fine. Thats probably a legally stated maximum fine. But you should pay a fine for your ignorance!

Last edited by omtatsat; 01.02.2020 at 08:01.
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  #22  
Old 01.02.2020, 08:36
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Re: Insurance Runaround

Thanks everyone for your input.
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Old 01.02.2020, 08:48
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Re: Insurance Runaround

The OP is actually relatively lucky. Imagine you have a serious health condition and US insurance wouldn't cover it.
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Old 01.02.2020, 09:09
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Re: Insurance Runaround

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The OP is actually relatively lucky. Imagine you have a serious health condition and US insurance wouldn't cover it.
That's why I asked if the OP had confirmation from his US insurance that he would be covered in CH.
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Old 01.02.2020, 09:37
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Re: Insurance Runaround

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The OP is actually relatively lucky. Imagine you have a serious health condition and US insurance wouldn't cover it.
There have been such cases already. Some didn't have any insurance, some had insurance but it didn't cover anything. In one case the final invoice for treatment was well over CHF 100'000.--. The canton where the incident happened had to pay the invoice!
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Old 18.06.2020, 14:54
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Re: Insurance Runaround

This matter has now finally concluded. I am posting this if only to help someone who might find themselves in the same situation at some time in the future.

The attorney I engaged eventually pressed the matter with our Gemeinde. With the current Gemeindeschreiber's assistance (the one I had dealt with had retired) it was determined that standard operating procedures set forth hadn't been followed and that it was, in fact, the retired Gemeindeschreiber's duty & responsibility to dig deeper into the status of my health insurance coverage prior to issuing a visa. Necessary documentation and written follow-up communication that would have clarified the Swiss healthcare mandate was never processed.

We appealed these findings to the Gemeinde officers and eventually came to a compromise whereby they accepted a lion's share of responsibility for damages (80%).

For those questioning the amount of the penalty, the full amount was CHF 4'967.15. As someone had noted, this amount is being paid off as an additional assessment to my monthly health insurance bill (roughly 44 monthly payments of CHF 112). This insurance company is simply acting as a conduit for collections.

I eventually received a direct payout from the Gemeinde in the amount of CHF 3'973.70. I had hoped to immediately pay down the remaining, unpaid, portion of the assessment through the insurer; however, they have no way to bill for the full, remaining balance. The matter will be finally put to bed in about 3 years after I finish making monthly installments.

Ultimately I'm pleased with the way this all ended. I'd like to thank those of you who at least attempted to provide constructive replies.
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