Ordinance of the Cantonal Council on Proceedings before the Insurance Court and on the Organisation and Proceedings of Arbitral Tribunals in Social Insurance

1. The Insurance Court adjudicates all disputes in social security matters, including occupational benefits, within the framework of federal and cantonal legislation.

2. Arbitration courts adjudicate, within the framework of federal and cantonal legislation, disputes between service providers and carriers of the following social insurances

a) Disability Insurance;

b) Health Insurance;

c) Accident Insurance;

d) Military Insurance.

3. Where this regulation does not provide a provision, the Act on Legal Protection in Administrative Matters applies.

1. Complaints and lawsuits must be submitted in writing.

2. They must contain a concise presentation of the facts, a legal request, and a justification. If they do not meet these requirements, the complainant or plaintiff will be granted a reasonable period to rectify them, with the warning that otherwise, the complaint or lawsuit will not be considered.

3. The legal document should include the contested decision and, if applicable, a power of attorney; evidence should be enclosed or precisely identified.

1. The appeal has a suspensive effect.

2. The lower court may remove the suspensive effect of a potential appeal; the same authority is granted to the instructing judge after the submission of the appeal.

3. The suspensive effect cannot be removed if the decision entails an obligation of the appellant to make a monetary payment.

4. The instructing judge may restore the suspensive effect removed by the lower court; a corresponding request must be decided without delay.

1. The instruction judge ensures the expedited course of the proceedings.

2. An attempt at reconciliation generally does not take place.

1. The insurance court independently establishes the facts relevant to the decision with the participation of the parties.

1. The Insurance Court is not bound by the parties' requests. It can modify a decision to the detriment of the appellant or award them more than requested; the parties are given the opportunity to comment beforehand.

2. In matters concerning military insurance, the plaintiff must be given the opportunity to amend the complaint (Art. 56 para. 1 lit. c of the Federal Act on Military Insurance of September 20, 1949; SR 833.1).

3. A party hearing takes place in cases provided for by federal law. The Insurance Court may order a party hearing in other cases, either upon request or ex officio. The hearing is generally public.

4. The judgment shall be delivered to the parties and, if required, to the relevant Federal Office in writing, with reasons and instructions on legal remedies, within 30 days from the issuance.

1. The procedure is generally free of charge.

2. In cases of reckless or vexatious litigation, a party may be imposed with the procedural costs along with a court fee.

3. The prevailing appellant or plaintiff is entitled to compensation for legal expenses at the expense of the losing social insurance institution. The compensation is determined irrespective of the value of the dispute, based on the circumstances of the case and the complexity of the proceedings.

1. Disputes between social insurance carriers on one hand, and the authorized service providers in the respective social insurance on the other hand, shall be adjudicated by an arbitration tribunal.

2. The arbitration tribunal comprises the President of the Insurance Court as the Chairperson and, according to the case to be handled, one representative each from the carriers of the respective social insurance on one side, and from the respective group of authorized service providers on the other side. Deputies for the Chairperson are the two other members of the Insurance Court.

3. The members of the arbitration tribunal are elected by the Cantonal Council upon proposal from the interested parties for a regular term of office. For the representation of the carriers of the respective social insurance, two substitute members are elected for each, and for the representation of the other interested parties, one substitute member is elected for each group of authorized service providers.

1. The complaint shall be submitted in writing to the presiding arbitrator of the arbitral tribunal.

2. An arbitration procedure for resolving a dispute must be preceded by a mediation process, unless an arbitration institution established by contract has already acted.

3. The mediation and arbitration procedures shall be conducted as expeditiously as possible.

1. The chairman schedules the mediation hearing. He may involve the members of the arbitration tribunal.

2. The parties must appear in person, with or without legal counsel. No party compensation is awarded for representation in the mediation process.

3. The mediation procedure is not public.

4. The parties may be required to record the facts in writing. They must submit the evidence that allows for an immediate clarification of the facts during the mediation process.

5. If the dispute cannot be resolved, the defendant must declare to what extent they acknowledge the claim.

1. The arbitration proceedings are in writing. The presiding arbitrator may order an oral hearing.

2. The parties may be represented. The presiding arbitrator may order personal appearance.

3. The arbitration hearings are public. The presiding arbitrator may exclude the public when protected interests so require. The deliberations of the arbitral tribunal are not public.

4. The arbitral tribunal is not bound by the parties' motions for evidence; it may order the taking of evidence ex officio.

5. The arbitral award is communicated to the parties and the Federal Social Insurance Office within 30 days of issuance, in writing, with reasons and instructions on legal remedies.

1. The costs of the mediation and arbitration proceedings, including the remuneration of the members of the arbitration tribunal, shall be fully borne by the parties. They shall be imposed on them in proportion to the extent of their defeat.

2. The remuneration of the members of the arbitration tribunal shall be determined by the government council.

3. The claimant may be required to provide an advance on costs for the arbitration proceedings, under the threat of the proceedings not being initiated.

1. An appeal against the decision of the arbitral tribunal can be lodged with the Swiss Federal Insurance Court within 30 days from the date of delivery by means of an administrative court appeal.

1. The arbitral tribunal is under the supervision of the higher court; the chairperson reports annually to it on the tribunal's activities.

1. Upon the entry into force of this regulation, all conflicting decrees are repealed, in particular

a) Sections 6-9 of the Ordinance on the Act for the Introduction of the Federal Law on Health and Accident Insurance of January 12, 1968;

b) Sections 5 and 6 of the Ordinance on the Federal Law on Accident Insurance of December 6, 1983.

1. This regulation enters into force upon approval by the Federal Council at the time determined by the Government Council, together with the amendment to the Law on Judicial Organization of June 28, 1987.