What to Do in Case of an Insurance Dispute
Steps for insurance disputes: contesting a decision, ombudsman, court proceedings and deadlines under the ICA and social insurance laws.
Last updated : 2026-04-24
Private Insurance (ICA)
Contesting a Benefit Refusal
- Request written, reasoned explanation 2. Contest in writing with arguments and supporting documents 3. Set reasonable payment deadline.
Insurance Ombudsman
Free, neutral mediator for private insurance disputes. Non-binding recommendations.
Court Proceedings
Forum: insured's domicile (art. 32 CPC). Mandatory conciliation (art. 197 CPC). Simplified procedure up to CHF 30,000 (art. 243 CPC). ICA prescription: five years (art. 46 ICA). Interrupt prescription if dispute persists.
Social Insurance (HIA, AIA, DI, OASI)
Objection Procedure
Social insurance decisions are administrative decisions. Object within 30 days (art. 52 ATSG). Free and must be reasoned. The insurer re-examines and issues an objection decision.
Cantonal Insurance Court
Appeal within 30 days of the objection decision (art. 56 ATSG). Procedure is free. Full review of facts and law.
Federal Supreme Court
Against cantonal judgment: public law appeal within 30 days (art. 100 FSCA). Social law division in Lucerne.
Health Insurance (HIA)
Basic insurance disputes: social insurance route (objection, then cantonal insurance court). Supplementary insurance disputes: civil route (ICA).
Practical Tips
Preserve all documents. Respect deadlines (30 days social insurance; 5 years ICA prescription). Send important correspondence by registered mail. Contact the ombudsman before litigation. Check if legal protection insurance covers the dispute.
Frequently Asked Questions
Is the insurance ombudsman free?
Yes. The private insurance ombudsman services are free for the insured. Non-binding mediation.
What is the deadline to contest a social insurance decision?
30 days for objection (art. 52 ATSG). Mandatory. Missing it means losing the right to contest.
Is the insurance court procedure paid?
No. Social insurance proceedings are free before the cantonal insurance court.
Editorial note
This article is provided for general information on Swiss law. It does not constitute legal advice and is no substitute for consulting a professional.
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