Ombudsman of Private Insurance and of Suva
The Ombudsman of Private Insurance and of Suva foundation was established by the SIA in 1972. The Ombudsman Office assists insured parties with questions related to insurance law and provides solution-oriented mediation for disputes. Its services are free of charge and impartial. The number of queries and complaints within the Ombudsman’s jurisdiction rose from 2,825 to 3,078 (8.9%) in 2024, the year under review. The increase in the caseload concerned most segments of the private insurance sector as well as the occupational benefits/Occupational Pensions Act (OPA) sector.
Summary of the Annual Report 2024
2,799 cases were resolved without intervention with the insurance companies or directly with the insured party or claimant. 299 of the 1254 complaints submitted in writing resulted in interventions with the relevant insurance companies (intervention rate 23.8%). The intervention success rate was in line with the long-term average and stood at around 62% whereby an improvement in the complainant’s situation was achieved in around 2 out of 3 intervention cases.
Our activities continued to focus on personal insurance which accounted for 49% of the caseload. Mandatory accident insurance/Accident Insurance Act (AIA) was top in terms of case numbers with 720 queries and complaints, followed by the daily allowance insurance sector where 426 cases were assessed. The processing of these cases often proved very time-consuming.
There was a sharp increase in the number of queries and complaints from 44 to 79 (79.5%) in the theft insurance sector. They often concerned the theft of bicycles. Queries related to the revised Insurance Policies Act/IPA, which entered into force on 1 January 2022, went up, particularly in relation to the direct right to claim under Art. 60 para. 1bis IPA. In addition to the approximately 13% increase in the number of cases in 2023 and 2024, there has also been a rise in the proportion of policyholders who have recently moved to Switzerland, do not speak the national languages, and are still familiarising themselves with the legal system. At the same time, an increasing number of policyholders are expressing dissatisfaction with the Ombudsman’s negative responses, resulting in more time-consuming casework.
Consequently, our mediation efforts are becoming more demanding. This trend mirrors the broader erosion of trust in institutions currently being discussed in the media and is likely to intensify. So far, the additional workload associated with this trend has been managed through increased efficiency – partly thanks to digital tools – and temporary increases in staff capacity.
The annual report reflects the activities of the Ombudsman's Office in the areas of private insurance, the LAA/UVG and occupational pensions. In addition to the development of cases in the individual areas and sectors, the activities in the three language regions are also analysed.
About the Ombudsman's Office
Within the scope of the Foundation's purpose, the Ombudsman's Office acts as an independent and neutral mediator in the event of differences of opinion between policyholders, insured persons, beneficiaries and applicants on the one hand and the private insurers affiliated to the Foundation and Suva, including the military insurance provided by Suva, on the other in insurance matters, as well as arising from mortgage loan agreements for residential property for personal use. Within the scope of its remit, it examines the complaints submitted to it, provides information and, if it deems it appropriate, makes representations to the insurer involved with a view to clarifying a specific matter submitted. It works towards a fair resolution of the conflict.
