Cantonal Insurance Court

What is the Cantonal Insurance Court?

The Cantonal Insurance Court is the cantonal court for disputes in social insurance matters. For health insurance, this means: it decides when you disagree with your health insurer’s response to the objection in basic health insurance. Federal law requires every canton to appoint such a court as the sole cantonal instance (Art. 57 of the Federal Act on the General Part of Social Insurance Law, ATSG).

The canton decides what the court is called and where it sits within the court system. In some cantons it is a separate social insurance court, in others a division of the administrative court. The address is given in the notice of appeal rights at the end of the response to the objection.

The Cantonal Insurance Court should not be confused with the cantonal arbitration tribunal. That tribunal decides disputes between health insurers and service providers, for example about tariffs and invoices (Art. 89 KVG). Insured persons are only involved there in exceptional cases.

How it works

The route to the Cantonal Insurance Court almost always passes through two stages with the insurer:

1. The insurer issues a written decision.
2. You file an objection within 30 days, and the insurer issues a response to the objection.
3. You file an appeal against the response to the objection with the Cantonal Insurance Court within 30 days (Art. 56 para. 1 and Art. 60 para. 1 ATSG).

There is one exception: if the insurer does not issue a written decision or a response to the objection despite your request, you can file an appeal directly for undue delay (Art. 56 para. 2 ATSG). The insurer may not make your right of appeal conditional on first contacting internal bodies (Art. 86 KVG).

The insurance court of the canton in which you live when you file the appeal is responsible (Art. 58 para. 1 ATSG). If you live abroad, the court of your last Swiss canton of residence or of the canton of your last Swiss employer is responsible (Art. 58 para. 2 ATSG). If you send the appeal to the wrong court, that court forwards it (Art. 58 para. 3 ATSG).

The canton governs the procedure, but federal law sets minimum standards (Art. 61 ATSG):

• simple, fast and, as a rule, public;
• the court establishes the facts itself and gathers evidence;
• the court is not bound by the requests;
• you can be represented, free of charge if necessary;
• if you win, you are entitled to reimbursement of your costs;
• the judgment is issued in writing, with reasons and a notice of appeal rights.

In disputes about benefits, the proceedings only incur costs if the relevant act provides for this. The KVG does not. The court can then only charge you court costs if you act recklessly or frivolously (Art. 61 let. fbis ATSG).

You can appeal the judgment of the Cantonal Insurance Court to the Federal Supreme Court under the Federal Supreme Court Act (Art. 62 para. 1 ATSG).

Legal basis

The legal basis is set out in Chapter 4 of the ATSG. Art. 56 ATSG grants the right of appeal against responses to objections and against written decisions that cannot be challenged by an objection, as well as in the event of undue delay. Art. 57 ATSG requires the cantons to appoint an insurance court as the sole instance. Art. 58 ATSG governs territorial jurisdiction according to place of residence. Art. 60 ATSG sets the deadline for appeals at 30 days and declares the rules on time limits in Art. 38–41 ATSG applicable by analogy, including the suspension of time limits. Art. 61 ATSG contains the rules of procedure, and Art. 62 ATSG the appeal to the Federal Supreme Court.

The KVG adds in Art. 86 that insurers may not make the right of appeal conditional on an internal review procedure. For supplementary insurance, the ATSG does not apply but the Swiss Civil Procedure Code (CPC) does: Art. 7 CPC allows the cantons to designate a court as the sole instance, and under Art. 113 para. 2 let. f and Art. 114 let. e CPC, no court costs are charged in conciliation or decision proceedings.

Example: an appeal over the Christmas holidays

Simon is 45. His insurer has rejected his objection. The response to the objection is delivered to him on Thursday, 03.12.2026. He calculates the deadline for the appeal under Art. 60 and Art. 38 ATSG:

What this means for you

• First check the objection. Without a response to the objection, there is normally no appeal. Exception: the insurer does not decide despite your request.
• Calculate the deadline carefully. 30 days, starting on the day after delivery, suspended over Easter, in summer and over Christmas.
• Keep the appeal simple. Facts, request, reasons, signature. The court establishes the facts itself.
• Use the ombudsperson early. The Office of the health insurance ombudsperson can often resolve a dispute before it goes to court. However, it does not stop the deadlines from running.

If you want to switch insurer after a legal dispute: the health insurers overview shows all insurers with their key figures, the premium calculator the premiums for your municipality, and switching health insurer the deadlines.

Common mistakes

• Going to court straight after the written decision. The objection to the insurer comes first. An appeal against a written decision that can be challenged by an objection is premature.
• Choosing the court where the insurer has its registered office. What counts is your canton of residence, not the insurer’s registered office.
• Applying the suspension incorrectly. It only extends the deadline by the days of suspension; the count does not start again.
• Mixing up supplementary and basic health insurance. The CPC applies to supplementary insurance. The canton decides which court is responsible.