Separation of KVG & VVG

At present, the separation of KVG & VVG is already given to a large extent:

  • Separate accounts are already kept for basic and supplementary insurance.
  • Oversight is performed by separate institutions: the FOPH supervises basic insurance, while FINMA is the regulator for supplementary insurance.
  • The premiums for basic and supplementary insurance are notified separately in statements to insured persons.
  • Service providers are required to issue separate bills for their services under KVG and VVG.
  • At present, it is not permitted to transfer any data between basic and supplementary insurance without the consent of the insured person.

Any additional separation would entail more costs and more time and effort on the part of the insured persons rather than eliminate any false incentives that might exist in the healthcare system. It is obvious that separating out the benefit statements could not be achieved easily or without incurring additional costs, given that it is a highly complex process in which IT and work processes are closely interwoven. By removing these synergies, each insurer's administration would become more expensive.

But a separation would also mean insured persons having to expend more time and effort. They would have to submit doctor's bills and supporting documents in duplicate, they would receive two separate statements for each line of insurance and would have two different contact points in case of questions. The latter would then have to coordinate among themselves. Insured persons appreciate being able to receive all their services from a single source. That is why the majority of insured persons take out both basic and supplementary insurance with the same insurer. It is already possible for insured persons to take out basic and supplementary insurance with different service providers, but very few currently do so.

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