Supplemental insurance: what are the reasons for rejection?

1. Rejected by supplemental insurance: why is this allowed?

Basic health insurance is compulsory for all residents in Switzerland. Health insurers are obliged to accept everyone who applies for basic insurance.

The situation is different with supplemental insurance, as it is optional and there is no obligation to accept you. Health insurers can reject applications from new insureds without having to give a reason.

2. What are the reasons why an application for supplemental insurance could be rejected?

There are no publicly available or statutory criteria for the rejection of supplemental insurance applications by health insurers. A health check plays an important role in whether you get accepted or not. Within the check, you must answer questions about any illnesses and treatments you have had in recent years truthfully.

Good to know: pre-existing conditions and genetic testing results will not necessarily lead to a rejection. But they may be a reason for health insurers to apply exclusions or to reduce the benefits they offer.

3. My application for supplemental insurance was rejected: what can I do?

Was your application for supplemental insurance rejected? There is usually nothing you can do about this. However, it may be worth submitting the application to another health insurer. The assessment criteria can vary greatly from one provider to another. Our tip: take a look at your patient file. This can give you an indication of why the health insurance company rejected your application. Check that the information in it is correct. You can have your patient file reviewed by the Schweizerische Patientenorganisation Foundation (SPO – "Swiss Patient Organisation").

4. Can the health insurer cancel my existing supplemental insurance?

Yes, the health insurer can cancel your existing supplemental insurance under certain conditions – but not arbitrarily or for discriminatory reasons. The health insurer may cancel your supplemental insurance for the following reasons (list not exhaustive):

• False information: in the event of false information having been verifiably provided in the application or health questionnaire, your supplemental insurance may be cancelled.

• Non-payment of premiums: In the event of repeated late payment of premiums, the insurance company may cancel your contract.

• End of contract period: After the agreed contract term has expired, the health insurer may cancel the contract in compliance with the contractual period.