Ombudsman of Private Insurance and of Suva

Portrait07 September 2018

The Foundation «Ombudsman of Private Insurance and of Suva» was established by the SIA in 1972. The Ombudsman has proven to be a solidly-founded and widely-accepted independent institution. The number of problems dealt with by the Ombudsman show that this institution enjoys the confidence and trust of the public at large. Its services – which it renders free of charge – contribute to assisting dissatisfied or uncertain customers.

Summary of the Annual Report 2017

The number of queries and complaints within the Ombudsman’s jurisdiction fell by 3.1% from 3,479 to 3,370 in 2017, the year under review.

A total of 2,991 cases were resolved directly with policyholders or complainants without the need to contact the insurer. 379 complaints resulted in interventions with the relevant insur-ance companies (intervention rate 24.6% on the basis of requests submitted in writing). Of these 96% were resolved before the end of the year. The intervention success rate stood at 66.2%. The highest dispute value in an intervention case was CHF 2 million while the lowest contested amount was CHF 117.

The Ombudsman’s activities primarily focused on personal insurance, which accounted for 54% of the caseload. In the daily sickness insurance sector, the number of cases in which incapacity for work due to psychological suffering was disputed between medical specialists continued to rise as in the previous years. There is no end in sight to this trend.

Overall, the Ombudsman had to deal with a wide range of problems. For the first time, it had to address liability and insurance issues concerning the use of drones.

The pre-formulated documents of some insurance brokers brought to light systematic adviso-ry shortcomings in the brokerage of pillar 3a retirement savings insurance.

With regard to travel insurance cases, we obtained a direct insight on site into the importance of emergency call centres in the event of serious health Problems.