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. In the second year of the coronavirus pandemic, the number of queries and complaints for the Ombudsman Office decreased, but the time spent processing individual cases increased.
Summary of the Annual Report 2021
The number of queries and complaints within the Ombudsman’s jurisdiction fell by 20.6% from 3,408 to 2,704 in 2021, the year under review. The handling of the individual cases became more time-consuming and complex because many policyholders have become more sensitive in the second year of the pandemic in the Ombudsman Office’s view.
A total of 2,452 cases were resolved directly with policyholders or complainants without the need to contact the insurance companies concerned. 252 of the 866 complaints submitted in writing resulted in interventions with the relevant insurance companies (intervention rate 29.1%). The intervention success rate stood at 71%.
The sharp decline in case numbers is mainly explained by pandemic-related reasons in the private insurance sector, as the number of complaints concerning the Covid-19 pandemic fell from 587 to 98. This primarily concerned epidemic insurance cases of restaurants and travel insurance cases, which were very high in the previous year, owing to the pandemic. The health crisis also had at least some impact on the decline in queries and complaints concerning accident insurance which fell from 692 to 548 as a result of postponed operations and changes to behaviour at work and during leisure time.
As in the past, the Ombudsman’s activities focused on often complex personal insurance policies which accounted for around 48% of case numbers in the year under review. Very few cases concerning long Covid have been submitted to the Ombudsman thus far. Based on past experience, this may be due to problems with insurers only arising after a certain period of time in the case of longer-lasting illnesses which means the Ombudsman Office may still be facing a delay in dealing with long Covid.
During the year under review, the Ombudsman began its new activity as the point of contact for policyholders with complaints against entries in the HIS, the reference and information system of Swiss damage insurers. HIS was launched operationally on 1 February 2021 by SVV Solution AG and supports private insurers with their efforts to prevent insurance fraud.
There was a significant increase in complaints against animal insurers in the year under review (from 23 to 138). A particularly common reason for the Ombudsman’s intervention here was excessively long processing times (of a few months) by the insurers concerned.
It is noticeable that the severe weather in summer 2021 resulted in hardly any disputes with private building, home contents and vehicle insurers for the Ombudsman Office. Even though the number of cases processed dropped in 2021, the statistics show that the Ombudsman of Private Insurance and of Suva foundation still fulfils a great need and enjoys the trust of insured parties as it celebrates its 50th anniversary in June this year.
The Ombudsman's website can be found here.