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I 2018 111 • VG SZ I 2018 111 KI-generiert

Insurance Coverage Dispute Over Massage Costs

Geschäftsnummer I 2018 111
Gericht / Behörde
Rechtsordnung Schweiz · Kanton Schwyz (CH-SZ)
Entscheiddatum
Originalquelle öffnen Entscheidsuche-Spiegel Maschinenlesbares Markdown (.md)

Legislator-Zusammenfassung

KI-generiert

The case involved a dispute over coverage for massage costs under a supplementary health insurance policy, where the claimant sought reimbursement from the insurer. The court reasoned that the insurer was not obligated to cover the massage costs because the provided medical certificate, while confirming the necessity of treatment, failed to sufficiently specify the type, frequency, and duration of the prescribed massages, which were required under the specific terms of the supplementary insurance policy for reimbursement.

Legislator-Regeste

KI-generiert

Insurance Coverage Dispute Over Massage Costs: The court reasoned that the insurer was not obligated to cover the massage costs because the provided medical certificate, while confirming the necessity of treatment, failed to sufficiently specify the type, frequency, and duration of the prescribed massages, which were required under the specific terms of the supplementary insurance policy for reimbursement.

Schlagwörter

KI-generiert
Deckung der Krankenversicherung Versicherungsausweis Kostenersatz medizinische Notwendigkeit Gesundheitszeugnis sozialversicherungsrechtliche Streitigkeit
KI-generiert
I 2021 51
Claimant v. Insurer: Coverage for Massage Costs for Chronic Ailments
V 2023 2
Midwifery Service Coverage Dispute
II 2023 2
Foreign Medical Treatment Reimbursement Dispute
I 2021 43
Health Insurer Coverage Dispute for Custom Hormone Substitution Therapy
V 2019 1
Insurer Reimbursement Action for Mistaken Medical Payments Following Definitive Non-Reimbursement Ruling

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Volltext

\n \n \n \n \n

\n\n| | | |\n I 2018 111 |\n |\n \n\n

\n \n \n \n \n

\n\n| | | |\n |\n Urteil vom 10. April 2019 |\n \n\n

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\n\n| | | |\n Besetzung |\n Dr.iur. Vital Zehnder, Vizepräsident |\n \n|\n |\n Dr.med. Bernhard Zumsteg, Richter Dr.med. Pierre Lichtenhahn, Richter |\n \n|\n |\n MLaw Manuel Gamma, Gerichtsschreiber |\n \n\n

\n \n \n \n \n \n

\n\n| | | |\n Parteien |\n A.________, \n Kläger, \n vertreten durch Rechtsanwalt lic.iur. B.________, |\n \n|\n |\n gegen |\n \n|\n |\n C.________ AG, \n Beklagte, |\n \n\n

\n \n \n \n \n \n

\n\n| | | |\n Gegenstand |\n Krankenversicherung (Forderung aus Zusatzversicherung zum KVG; Massage-Kosten) |\n \n\n

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Sachverhalt: