Insurance Law in Switzerland
Insurance law constitutes a complex legal domain that affects virtually every aspect of personal and professional life in Switzerland. Given the multiple regulations and often delicate interpretation of insurance contracts, the intervention of a specialist lawyer becomes a necessity for many insured persons. Our Swiss law firm accompanies individuals and businesses in defending their interests against insurers, whether in social or private insurance matters. Our expertise covers policy analysis, negotiation with insurance companies, contesting unfavourable decisions and representation before courts to obtain legitimate compensation.
Areas of Practice in Insurance Law
Insurance law in Switzerland is divided primarily between social insurance and private insurance, each governed by specific legislation. Our law firm operates in both fields with in-depth expertise in the legal subtleties specific to each type of insurance.
In the field of social insurance, we assist our clients with all questions relating to the OASI (Old-Age and Survivors' Insurance), DI (Disability Insurance), ELC (Earnings Loss Compensation), UI (Unemployment Insurance), as well as mandatory accident insurance (MAIA) and mandatory health insurance (MHI). Our intervention covers particularly:
- Contesting decisions refusing benefits
- Assistance in administrative appeal procedures
- Defending rights in the event of reduction or suppression of pensions
- Assistance in establishing the degree of invalidity
- Coordination between the various social insurances
Regarding private insurance, our expertise extends to civil liability insurance (RC), legal protection insurance, life insurance, loss of earnings insurance, property insurance and supplementary health insurance. Our lawyers intervene notably for:
Personal Insurance
We analyse life, supplementary health and loss of earnings insurance contracts to verify the exact extent of coverage and defend your rights in the event of a dispute. Our expertise allows us to identify abusive clauses and contest unjustified refusals of benefits.
Property and Liability Insurance
In the event of a claim affecting your assets or if your liability is called into question, we ensure that your insurer fulfils its contractual obligations and pays you the compensation to which you are entitled. Our intervention includes damage assessment, negotiation with experts and contesting unfavourable decisions.
Our law firm is distinguished by its thorough knowledge of the Federal Act on Insurance Contracts (ICA) and associated case law, allowing effective defence of our clients' interests against insurers.
Procedure for Contesting Insurance Decisions
Contesting an insurance decision follows a rigorous process that must respect strict deadlines. Our law firm is perfectly familiar with these procedures and accompanies its clients at every stage.
For social insurance, the contestation procedure generally begins with an objection to be filed within 30 days of notification of the decision. This objection must be reasoned and documented to have any chance of success. If the objection is rejected, an appeal may be filed with the cantonal insurance court, then, as a last resort, with the Federal Supreme Court.
In the field of private insurance, contesting a decision first requires a written complaint addressed to the insurer. If negotiations fail, legal action may be brought before the civil courts.
Our intervention includes:
- Detailed analysis of the contested decision and its legal basis
- Collection and organisation of the necessary evidence (medical reports, expert assessments, testimonies)
- Drafting of procedural acts in compliance with formal requirements
- Precise calculation of the compensation claimed
- Representation at hearings and expert assessments
Expertise in Disability Insurance
Disability insurance (DI) constitutes a particularly complex area of insurance law in Switzerland. Our law firm has in-depth expertise in this sector and accompanies many insured persons in their dealings with the DI office.
Recognition of a disability and determination of its degree often represent an obstacle-strewn journey. The evaluation criteria are strict and medical expert assessments play a decisive role. Our specialist lawyers intervene at all stages of the procedure:
Initial Application for DI Benefits
We assist our clients from the constitution of the initial file, ensuring the gathering of all relevant medical elements and the correct completion of administrative forms. This phase is fundamental as it shapes the entire subsequent procedure.
Contesting DI Decisions
In the event of refusal or granting of an insufficient degree of invalidity, we prepare solidly reasoned objections, drawing on recent case law and supplementary medical expert assessments where necessary.
Appeals Before Courts
Our firm represents insured persons before the cantonal insurance courts and, if necessary, before the Federal Supreme Court. We develop rigorous legal arguments, highlighting the errors of appreciation made by the DI office.
Defending Insured Persons Against Health and Accident Insurers
Disputes with health and accident insurers are among the most frequent in insurance law. Our law firm defends the rights of insured persons facing coverage refusals or restrictive interpretations of contracts on a daily basis.
In the field of mandatory health insurance (MHI/LAMal), our lawyers intervene primarily to contest:
- Refusals to reimburse healthcare costs
- Decisions concerning off-list medications
- Disputes relating to treatment abroad
- Disputes related to premiums and deductibles
For supplementary health insurance, governed by the ICA, our expertise covers:
- Interpretation of exclusion clauses
- Contesting alleged non-disclosure invoked by the insurer
- Defence in the event of abusive contract terminations
- Analysis of coverage limitations