Annual report


You can also download the annual report 2016 in German or French.

 

Summary of the Annual Report 2016

The number of queries and complaints within the Ombudsman’s jurisdiction rose by 16.6% from 2,982 to 3,479 in 2016, the year under review.

A total of 3,081 cases were resolved directly with policyholders or complainants without the need to contact the insurer. 398 complaints resulted in interventions with the relevant insurance companies (intervention rate: 24.3%). Of these 95% were resolved before the end of the year. The intervention success rate stood at 67.4%. The highest dispute value in an intervention was CHF 700,000 while the lowest contested amount was CHF 120.

As in previous years, the Ombudsman’s activities primarily focused on personal insurance, which accounted for 50% 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.

The Ombudsman had to deal with coverage issues concerning “bed and breakfast” providers for the first time. There was dispute here over the insurance protection provided by the existing contents insurance policy and whether or not commercial insurance was required to cover the existing risks as accommodation providers renting rooms to travellers in their homes or apartments.

With the continuing increase in the number of complaints against mobile phone insurers, the Ombudsman had to assess on various occasions whether the insurer could refuse the compensation claimed for the theft of smartphones based on a clause in the general terms and conditions of insurance on the grounds that appropriate safekeeping of the item concerned was not ensured.

In the year under review, several complaints in the travel insurance sector concerned refusal of payment owing to preventative cancellation of travel in areas where the Zika virus had been detected.