Go Back   English Forum Switzerland > Help & tips > Permits/visas/government  
Reply
 
Thread Tools Display Modes
  #1  
Old 31.01.2020, 14:41
Newbie
 
Join Date: Jan 2020
Location: Schaffhausen
Posts: 5
Groaned at 3 Times in 1 Post
Thanked 6 Times in 3 Posts
videodude has earned some respectvideodude has earned some respect
Insurance Runaround

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.
Reply With Quote
The following 2 users would like to thank videodude for this useful post:
The following 3 users groan at videodude for this post:
  #2  
Old 31.01.2020, 14:52
Guest
 
Posts: n/a
Re: Insurance Runaround

Quote:
View Post
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.
Your US coverage almost certainly would not have been valid here, and although you maybe didn't realise, it was up to you to prove to the Swiss authorities that it was. It's very unusual that a foreign health insurance is acceptable, and certainly not by default, i.e. you'd have had to take some action to extend its validity to the satisfaction of the Swiss rules.

So I think you'll almost certainly just have to bite the bullet on this, painful as it may be. The fact was (almost certainly) that you weren't actually covered and (definitely) that you hadn't proven that you were, and although it's not nice, ignorance of the rules is no excuse.

Last edited by Guest; 31.01.2020 at 15:05. Reason: typo
Reply With Quote
The following 4 users would like to thank for this useful post:
  #3  
Old 31.01.2020, 14:58
grumpygrapefruit's Avatar
Forum Legend
 
Join Date: Feb 2007
Location: NL, UK & sometimes ZH
Posts: 6,367
Groaned at 38 Times in 37 Posts
Thanked 17,365 Times in 4,464 Posts
grumpygrapefruit has a reputation beyond reputegrumpygrapefruit has a reputation beyond reputegrumpygrapefruit has a reputation beyond reputegrumpygrapefruit has a reputation beyond reputegrumpygrapefruit has a reputation beyond reputegrumpygrapefruit has a reputation beyond repute
Re: Insurance Runaround

Did you notify your US insurance that you were not resident in the US and ask if they would cover you for Swiss Dr and Hospital visits? If they said yes and you have that in writing, you might be able to use this as a lever to get the penalty reduced. But as Ace has said, it's very rare for the Swiss to accept foreign health insurance once you are a resident here.
Reply With Quote
The following 3 users would like to thank grumpygrapefruit for this useful post:
  #4  
Old 31.01.2020, 15:59
Banned
 
Join Date: Dec 2017
Location: Zurigo
Posts: 294
Groaned at 16 Times in 12 Posts
Thanked 200 Times in 115 Posts
qwertz is considered knowledgeableqwertz is considered knowledgeableqwertz is considered knowledgeable
Re: Insurance Runaround

Everyone resident in Switzerland must take up Swiss health insurance within 3 months of their arrival no discussion.

Main exemptions:
- Foreign students (i.e. that came to Switzerland to study) can contract a cheaper insurance that provides for exemption of Swiss health insurance during their period of study up to 6 years maximum. Students from the EU/EFTA can become exempt upon producing their respective country’s European health insurance card
- Workers within the EU/EFTA that are resident in Switzerland (covered by the state they work in)

Everyone else must take up Swiss insurance within 3 months, else a pro-rated fine amounting to 30-50% of the premium and the number of days between the end of the 3 month period and the start of coverage will be charged. This fine can be contested directly to the insurance provider if it puts the insured person in financial difficulty and there are valid reasons why the insurance wasn’t taken up within 3 months of arrival in Switzerland.

You can read all the details under the relevant KVG law and ordinance but it will be up to the insurer to decide whether to levy the fine. I don’t think a lawyer is necessary.

Last edited by qwertz; 31.01.2020 at 16:15.
Reply With Quote
The following 3 users would like to thank qwertz for this useful post:
  #5  
Old 31.01.2020, 16:00
aSwissInTheUS's Avatar
Forum Legend
 
Join Date: Nov 2007
Location: Zurich area
Posts: 12,783
Groaned at 99 Times in 88 Posts
Thanked 19,576 Times in 8,681 Posts
aSwissInTheUS has a reputation beyond reputeaSwissInTheUS has a reputation beyond reputeaSwissInTheUS has a reputation beyond reputeaSwissInTheUS has a reputation beyond reputeaSwissInTheUS has a reputation beyond reputeaSwissInTheUS has a reputation beyond repute
Re: Insurance Runaround

First, it is permit B. The visa you might got was a visa D Permit B is a full fledged residence permit with all strings attached.

Next, Switzerland knows two concepts: Selberschuld and Bringschuld.

The first means, it is mostly always your fault (specially when you hurt yourself). The second, means the burden to provide and seek information is upon you.

All laws and regulation can be found here: https://www.admin.ch/opc/de/classifi.../national.html
the law regarding mandatory health insurance is here:
https://www.admin.ch/opc/de/classifi...073/index.html

So, Selberschuld if you did not read and understand the law. Selberschuld if you made a false statement on a government form. Selberschuld if you did not ask for clarification. Selberschuld if were not aware that if you get a permit B, register with the commune that you are proper Swiss resident and have certain obligations.

Next you might find out your Swiss tax might not be in order as you did not report all of your worldwide income and assets. At least with tax there is a literal once in a life time opportunity of self declaration w/ impunity (only valid if the tax authority does not already know about your misdeeds through other sources).
__________________
On Hiatus- Normal operation will resume 22.02.2022 22:02:20.22
Reply With Quote
The following 4 users would like to thank aSwissInTheUS for this useful post:
  #6  
Old 31.01.2020, 16:08
aSwissInTheUS's Avatar
Forum Legend
 
Join Date: Nov 2007
Location: Zurich area
Posts: 12,783
Groaned at 99 Times in 88 Posts
Thanked 19,576 Times in 8,681 Posts
aSwissInTheUS has a reputation beyond reputeaSwissInTheUS has a reputation beyond reputeaSwissInTheUS has a reputation beyond reputeaSwissInTheUS has a reputation beyond reputeaSwissInTheUS has a reputation beyond reputeaSwissInTheUS has a reputation beyond repute
Re: Insurance Runaround

Quote:
View Post
but it will be up to the insurer to decide whether to levy the fine. I don’t think a lawyer is necessary.
The insurance can not levy a fine. The maximum the insurance can do is to increase the monthly premium for a certain period. Based on Art. 5 KVG https://www.admin.ch/opc/de/classifi.../index.html#a5 and Árt. 8 KVV https://www.admin.ch/opc/de/classifi.../index.html#a8

If there is a fine, or even more likely a monetary penalty it will be based on Art. 92 KVG and will come from a criminal prosecutor or judge https://www.admin.ch/opc/de/classifi...index.html#a92

There will be a criminal record entry if it is a fine (Busse) of more than CHF 5000 or a if it is a monetary penalty (Geldstrafe) of any amount.
__________________
On Hiatus- Normal operation will resume 22.02.2022 22:02:20.22
Reply With Quote
The following 3 users would like to thank aSwissInTheUS for this useful post:
  #7  
Old 31.01.2020, 16:14
Banned
 
Join Date: Dec 2017
Location: Zurigo
Posts: 294
Groaned at 16 Times in 12 Posts
Thanked 200 Times in 115 Posts
qwertz is considered knowledgeableqwertz is considered knowledgeableqwertz is considered knowledgeable
Re: Insurance Runaround

Quote:
View Post
The insurance can not levy a fine. The maximum the insurance can do is to increase the monthly premium for a certain period. Based on Art. 5 KVG https://www.admin.ch/opc/de/classifi.../index.html#a5 and Árt. 8 KVV https://www.admin.ch/opc/de/classifi.../index.html#a8

If there is a fine, or even more likely a monetary penalty it will be based on Art. 92 KVG and will come from a criminal prosecutor or judge https://www.admin.ch/opc/de/classifi...index.html#a92

There will be a criminal record entry if it is a fine (Busse) of more than CHF 5000 or a if it is a monetary penalty (Geldstrafe) of any amount.

The fine and a potential levy or reduction is of the insurer’s competence as per Art. 8 of the KVG ordinance

https://www.admin.ch/opc/de/classifi.../index.html#a8
Reply With Quote
  #8  
Old 31.01.2020, 16:22
aSwissInTheUS's Avatar
Forum Legend
 
Join Date: Nov 2007
Location: Zurich area
Posts: 12,783
Groaned at 99 Times in 88 Posts
Thanked 19,576 Times in 8,681 Posts
aSwissInTheUS has a reputation beyond reputeaSwissInTheUS has a reputation beyond reputeaSwissInTheUS has a reputation beyond reputeaSwissInTheUS has a reputation beyond reputeaSwissInTheUS has a reputation beyond reputeaSwissInTheUS has a reputation beyond repute
Re: Insurance Runaround

Quote:
View Post
The fine and a potential levy or reduction is of the insurer’s competence as per Art. 8 of the KVG ordinance

https://www.admin.ch/opc/de/classifi.../index.html#a8
Exactly what I linked to But it is not a fine If we speak about laws and consequences the term 'fine' has a very certain distinct meaning given by the Art. 106 Swiss Criminal Code. Accordingly, the above is not a fine.
Reply With Quote
The following 2 users would like to thank aSwissInTheUS for this useful post:
  #9  
Old 31.01.2020, 16:23
Guest
 
Posts: n/a
Re: Insurance Runaround

Quote:
View Post
The fine and a potential levy or reduction is of the insurer’s competence as per Art. 8 of the KVG ordinance

https://www.admin.ch/opc/de/classifi.../index.html#a8
Fines are issued by the government, insurance can only raise the monthly premium for a limited period.

Just think of it: Which insurance should hand out a fine if somebody was here for let's say two year but never was insured?
Reply With Quote
  #10  
Old 31.01.2020, 16:28
Banned
 
Join Date: Dec 2017
Location: Zurigo
Posts: 294
Groaned at 16 Times in 12 Posts
Thanked 200 Times in 115 Posts
qwertz is considered knowledgeableqwertz is considered knowledgeableqwertz is considered knowledgeable
Re: Insurance Runaround

Fine poor translation, not a ‘fine’ but an ‘insurance premium supplement’. In any case for OP futile to loop their town hall or canton in this, it is to be settled directly with the insurance provider
Reply With Quote
  #11  
Old 31.01.2020, 16:35
Guest
 
Posts: n/a
Re: Insurance Runaround

Quote:
View Post
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.
Just noticed this statement, which I missed earlier - made me laugh, it did.

You could apply the same logic to many other things if it were to hold water - e.g. sorry, officer, nobody asked me to prove I had a valid driving licence, I just assumed I could go on using a foreign one for ever and no-one told me otherwise, it's the fault of the system, I tell you!.
Reply With Quote
The following 2 users would like to thank for this useful post:
  #12  
Old 31.01.2020, 16:53
aSwissInTheUS's Avatar
Forum Legend
 
Join Date: Nov 2007
Location: Zurich area
Posts: 12,783
Groaned at 99 Times in 88 Posts
Thanked 19,576 Times in 8,681 Posts
aSwissInTheUS has a reputation beyond reputeaSwissInTheUS has a reputation beyond reputeaSwissInTheUS has a reputation beyond reputeaSwissInTheUS has a reputation beyond reputeaSwissInTheUS has a reputation beyond reputeaSwissInTheUS has a reputation beyond repute
Re: Insurance Runaround

Quote:
View Post
In any case for OP futile to loop their town hall or canton in this, it is to be settled directly with the insurance provider
No or maybe.
First, we do not know if the 'penalty' OP mentions is just an increased premium or an actual monetary penalty from the state attorney or court.

Second, the competent authority to grant an exemption from Swiss health insurance for residents in Schaffhausen is the SVA Schaffhausen.
https://www.bag.admin.ch/dam/bag/de/...efreiung-d.pdf

Third, the insurance will have issued a formal decision (Verfügung) about the increased premiums. This decision must also state where, how, when an objection can be lodged. This has normally be done at the cantons insurance court.

If there is indeed no formal decision from the insurance the first step is to request one and then formally object against it.
__________________
On Hiatus- Normal operation will resume 22.02.2022 22:02:20.22
Reply With Quote
The following 2 users would like to thank aSwissInTheUS for this useful post:
  #13  
Old 31.01.2020, 18:23
Guest
 
Posts: n/a
Re: Insurance Runaround

I don't think the insurance send a bill for thousands, after 3 months the health insurances do no longer have to be retro-active, so it would make no sense for the insurance to send a bill of thousands.
Reply With Quote
  #14  
Old 31.01.2020, 19:25
Banned
 
Join Date: Dec 2017
Location: Zurigo
Posts: 294
Groaned at 16 Times in 12 Posts
Thanked 200 Times in 115 Posts
qwertz is considered knowledgeableqwertz is considered knowledgeableqwertz is considered knowledgeable
Re: Insurance Runaround

Incorrect, it is the insurance provider that is mandated to charge the premium supplement.

The cantonal health insurance office never issues payment orders and only deals with granting exemptions, premium subsidies and controlling the population in their competence is insured as per the law. It is then up to the insurance company to discount premiums if a subsidy has been granted or charge supplements in case of late subscription to the insurance.
Reply With Quote
  #15  
Old 31.01.2020, 20:23
Guest
 
Posts: n/a
Re: Insurance Runaround

Quote:
View Post
Incorrect, it is the insurance provider that is mandated to charge the premium supplement.

The cantonal health insurance office never issues payment orders and only deals with granting exemptions, premium subsidies and controlling the population in their competence is insured as per the law. It is then up to the insurance company to discount premiums if a subsidy has been granted or charge supplements in case of late subscription to the insurance.
Do you even read other postings in this topic or are you just randomly typing stuff?

As for your posting:

- Health insurance no longer is retro-active.
- Extra charge in premium is limited to 50%

Now tell us: According to what logic would an insurance send a bill of thousands.

Just makes no sense at all.
Reply With Quote
  #16  
Old 31.01.2020, 20:36
Banned
 
Join Date: Dec 2017
Location: Zurigo
Posts: 294
Groaned at 16 Times in 12 Posts
Thanked 200 Times in 115 Posts
qwertz is considered knowledgeableqwertz is considered knowledgeableqwertz is considered knowledgeable
Re: Insurance Runaround

Just because it doesn’t make sense to you doesn’t mean things are done one way or another.

It is not up to me to question the logic of some procedures of the health insurance ordinance. It is very simple: the insurance company sends premium supplement bills in parallel to monthly premiums unless the insured person contests the supplement in writing to the insurance company.

Have you by any chance been charged with this premium supplement and can start adding value to the thread from first hand experience?
Reply With Quote
This user groans at qwertz for this post:
  #17  
Old 31.01.2020, 20:53
Guest
 
Posts: n/a
Re: Insurance Runaround

Quote:
View Post
Just because it doesn’t make sense to you doesn’t mean things are done one way or another.

It is not up to me to question the logic of some procedures of the health insurance ordinance. It is very simple: the insurance company sends premium supplement bills in parallel to monthly premiums unless the insured person contests the supplement in writing to the insurance company.

Have you by any chance been charged with this premium supplement and can start adding value to the thread from first hand experience?
Such nonsense.

They don't send supplement bills in parallel, they can raise the monthly premium and just send one monthly bill for that.

You have not yet answered my question:

Quote:
Now tell us: According to what logic would an insurance send a bill of thousands.

From OP:

Quote:
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.
Health insurances can't issue penalties of several thousands.
Reply With Quote
The following 2 users would like to thank for this useful post:
The following 2 users groan at for this post:
  #18  
Old 31.01.2020, 21:09
aSwissInTheUS's Avatar
Forum Legend
 
Join Date: Nov 2007
Location: Zurich area
Posts: 12,783
Groaned at 99 Times in 88 Posts
Thanked 19,576 Times in 8,681 Posts
aSwissInTheUS has a reputation beyond reputeaSwissInTheUS has a reputation beyond reputeaSwissInTheUS has a reputation beyond reputeaSwissInTheUS has a reputation beyond reputeaSwissInTheUS has a reputation beyond reputeaSwissInTheUS has a reputation beyond repute
Re: Insurance Runaround

From federal court ruling BGE 129 V 267 we know that the premium supplement results in an increased monthly premium (in percents) and must not be billed otherwise, specially not in a single installment. Quite logically, as the future monthly premium is not known and the supplement is a percentage of the premium.
Reply With Quote
This user would like to thank aSwissInTheUS for this useful post:
  #19  
Old 31.01.2020, 21:15
Guest
 
Posts: n/a
Re: Insurance Runaround

https://www.admin.ch/opc/de/classifi...000/832.10.pdf

Art 92 defines the amount of the sanction when skipping the insurance duty due to not telling the truth at a maximum of 180 daily earnings
Reply With Quote
This user would like to thank for this useful post:
  #20  
Old 31.01.2020, 21:29
roegner's Avatar
Moderately Dutch
 
Join Date: May 2011
Location: Zurich
Posts: 11,054
Groaned at 363 Times in 304 Posts
Thanked 13,880 Times in 6,479 Posts
roegner has a reputation beyond reputeroegner has a reputation beyond reputeroegner has a reputation beyond reputeroegner has a reputation beyond reputeroegner has a reputation beyond reputeroegner has a reputation beyond repute
Re: Insurance Runaround

Quote:
https://www.admin.ch/opc/de/classifi...000/832.10.pdf

Art 92 defines the amount of the sanction when skipping the insurance duty due to not telling the truth at a maximum of 180 daily earnings
Ouch
Reply With Quote
Reply

Tags
compulsory, health insurance, switzerland




Currently Active Users Viewing This Thread: 1 (0 members and 1 guests)
 
Thread Tools
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are Off
Pingbacks are Off
Refbacks are Off


Similar Threads
Thread Thread Starter Forum Replies Last Post
Health insurance - from an exemption to an obligatory insurance with 1 month break davidz Insurance 20 19.08.2019 15:25
Baby Insurance Prior to Birth - Supplementary Insurance Needed SwissNoobie Insurance 11 08.07.2019 11:42
Newborn fee trap: mother has foreign health insurance but baby has Swiss insurance wellswulsin Family matters/health 0 16.04.2016 11:18
European Health Insurance Card coverage and complementary private insurance SilviaGiorgetti Insurance 10 19.08.2015 21:20
Spider or poisonous insect bite - Accident insurance or Sickness Insurance colinwheeler Insurance 36 26.08.2011 14:34


All times are GMT +2. The time now is 03:54.


Powered by vBulletin® Version 3.8.4
Copyright ©2000 - 2021, Jelsoft Enterprises Ltd.
LinkBacks Enabled by vBSEO 3.1.0