Ser­vices for med­ical doc­tors and case man­agers

Recommendation25 February 2019

The insurance medicine arm of the Swiss Insurance Association covers all aspects of evaluating the medical risks related to insurance applications and assessing claims from a medical perspective.

Among other services, the insurance medicine arm of the Swiss Insurance Association offers standardised forms to cover various topics. Medical doctors, case managers, medical insurance officers and other interested parties can download those forms and reports here to support their daily work.

Insurers can also insert their logo and/or other text modules at the head or foot of those documents.

Obtaining medical reports is subject to the following rules:

  • No power of attorney is needed under the Federal Act on Accident Insurance (UVG): medical reports are sent directly to the insurer and in most cases to the insurance specialist in charge (UVG art. 54a).

  • No power of attorney is needed under the Health Insurance Act (KVG): medical reports are sent to the medical officer of the health insurer in charge (KVG art. 57)

  • In all other cases, powers of attorney are necessary (supplementary insurance to the UVG and/or KVG under the Federal Act on Insurance Contracts (VVG), liability insurance) for the medical report to be sent directly to the insurer. In most cases, these reports will be addressed to the insurance specialist in Charge.

Cooperations and partners

When dealing with complex issues, cooperation is a must. For this reason, we aim for quality improvements in insurance medicine. The exchange of views through Swiss Insurance Medicine is of essential importance to us.

Medical report (benefits) only available in German/French/Italian

Medical documentation form only available in German/French/Italian

Case Management only available in German/French/Italian

Gutachtenevaluation

Medical report (insurance application)