Annual report

The Insurance Ombudsman provides the annual report in German and French.

You can also download it in German or French.

OMBUDSMAN OF PRIVATE INSURANCE AND OF SUVA

Summary of the Annual Report 2010

3983 cases were submitted to the Ombudsman in 2010. Of that number, we could not deal with 511 for lack of jurisdiction. Most queries outside our jurisdiction concerned social health insurance issues, within the remit of the Health Insurance Ombudsman.

The Ombudsman handled 3472 inquiries and complaints within its jurisdiction. This was 333 less than in the previous year. By language region, the decline in the number of cases has been above all in German-speaking Switzerland (from 3178 to 2750), while the figures in Italian-speaking Switzerland (a change from 244 to 240) have remained almost constant, and in French-speaking Switzerland have grown significantly (from 383 to 482).

Notwithstanding an overall decline in case numbers, 2010 was a very intensive year. As in the previous years, the complexity of complaints in personal insurance cases has increased. Their share in the total of processed cases grew from 54% to 56.3%. Also higher than in the previous years was the number of large cases - with complex causality issues - where various health problems existed already on the occurrence of the insured event. There was also an increase in the number of complaints against early termination of daily allowance and occupational disability benefits, where opinions of the treating physician and the insurer's consulting physician diverged diametrically. Furthermore, the Ombudsman was heavily engaged in numerous, legally complex complaints related to policyholder information upon conclusion of a single-premium, funds-linked policy without benefit guarantee in the event of survival.

3072 cases could be settled directly with insured persons or claimants. 400, or 11.5% of cases required Ombudsman intervention.

131 intervention cases (32.8%) required multiple interventions. These concerned mostly life, sickness daily allowance and accident Insurance, where most often complex questions of fact and law arise. As in the previous year, it was necessary in almost every second daily allowance and life insurance case to intervene with insurance companies. In these, as well as in accident insurance cases, the positions of the parties were often very far apart. Bridging that gap required therefore intensive negotiations.

66.4% of the intervention cases were settled to the complainant's satisfaction.