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I 2021 19 • VG SZ I 2021 19 KI-generiert

Sickness Benefit Denial Due to Insufficient Medical Documentation

Geschäftsnummer I 2021 19
Gericht / Behörde
Rechtsordnung Schweiz · Kanton Schwyz (CH-SZ)
Entscheiddatum
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Legislator-Zusammenfassung

KI-generiert

The case concerns a dispute over sickness benefits under mandatory health insurance, where the claimant sought daily sickness benefits after an alleged illness, but the insurer denied the claim. The court reasoned that although the claimant reported symptoms and underwent medical examinations, the medical documentation did not sufficiently establish an incapacity to work caused by a specific illness, leading to the rejection of the claim for daily benefits.

Legislator-Regeste

KI-generiert

Sickness Benefit Denial Due to Insufficient Medical Documentation: The court reasoned that although the claimant reported symptoms and underwent medical examinations, the medical documentation did not sufficiently establish an incapacity to work caused by a specific illness, leading to the rejection of the claim for daily benefits.

Schlagwörter

KI-generiert
Versicherungsleistungsbegehren Krankenversicherung Ärztliche Untersuchung medizinische Gründe Pflichtleistung Arbeitsunfähigkeit
KI-generiert
I 2021 11
Appeal of Disability Insurance Denial Based on Insufficient Medical Evidence
I 2020 21
Invalidity Insurance Pension Denial Due to Insufficient Medical Evidence
I 2021 70
Denial of Disability Insurance Benefits Upheld Due to Insufficient Medical Evidence of Impairment
I 2022 40
Insured Recovers Sickness Benefits Despite Alleged Pre-Existing Condition Misrepresentation
I 2019 80
Dispute Over Sickness Daily Benefits

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Volltext

\n \n \n \n \n

\n\n| | | |\n I 2021 19 |\n |\n \n\n

\n \n \n \n \n

\n\n| | | |\n |\n Urteil vom 19. Oktober 2021 |\n \n\n

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\n\n| | | |\n Besetzung |\n Dr.iur. Vital Zehnder, Vizepräsident |\n \n|\n |\n Dr.med. Urs Gössi, Richter Dr.med. Pierre Lichtenhahn, Richter |\n \n|\n |\n MLaw Stefanie Zlauwinen, a.o. Gerichtsschreiberin |\n \n\n

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

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

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

\n\n| | | |\n Gegenstand |\n Krankenversicherung (Krankentaggeld nach VVG) |\n \n\n

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Sachverhalt: