Payment arrears

What are payment arrears?

You are in payment arrears if you have not paid amounts owed to your health insurer that are due. In basic health insurance, these are the monthly premiums, which are due in advance, and the co-payments, meaning the deductible and retention fee that your insurer bills you for after a treatment. The law speaks of the “non-payment of premiums and co-payments” and describes people with outstanding amounts as being “in arrears”.

Unlike a mobile phone contract, your insurer cannot simply cancel your basic health insurance. The insurance is compulsory, so the contract remains in place. Instead, the law sets out precisely how the insurer must send reminders and initiate debt enforcement, what consequences the arrears have, and when the canton takes over part of the debt.

Different rules apply to supplementary insurance. It is governed by the Insurance Contract Act (ICA), not by the Health Insurance Act (KVG). There, the insurer can suspend its benefits as long as you are in default. More on this under “Legal basis”.

For children, the parents owe the premiums. The same procedural rules apply to a child’s arrears, but they are directed against the parents or the parent who owes the premiums.

How it works

The procedure in basic health insurance follows fixed steps:

1. Reminder: If you do not pay a premium or co-payment, your insurer sends you at least one written reminder. From this reminder on, you are considered to be in arrears.
2. Demand for payment: The insurer then serves you a demand for payment, at the latest three months after the due date and separately from other outstanding amounts. It gives you a 30-day grace period and informs you of the consequences.
3. Debt enforcement: If you still do not pay, the insurer must initiate debt enforcement. Per calendar year it may initiate debt enforcement against you at most twice for your own arrears and twice for a child’s arrears.
4. Certificate of unpaid debt: If debt enforcement ends without full payment, the insurer receives a certificate of unpaid debt (Verlustschein). It reports the claim to the canton, and the canton takes over 85% of it. This does not make the debt disappear for you: the insurer keeps the certificate until everything has been paid and passes on 50% of what you pay later to the canton.

Default interest of 5% a year is added to premiums that are due. If you cause additional work, the insurer may charge administrative fees if its rules provide for this; the maximum amounts are set by the Federal Department of Home Affairs.

What matters is what the insurer is not allowed to do: it may not offset your benefits against unpaid premiums. If you submit a doctor’s bill, it must pay its share, even if you are in arrears.

Legal basis

The core provision is Art. 64a KVG (“Non-payment of premiums and co-payments”):

• Para. 1: At least one written reminder, then a demand for payment with a 30-day grace period and a reference to the consequences.
• Para. 2: Obligation to initiate debt enforcement; at most two debt enforcement proceedings per calendar year each for your own arrears and for a child’s arrears.
• Para. 3 and 4: Reporting of certificates of unpaid debt to the canton; the canton takes over 85% of the reported claims, and the insurer pays back 50% of later payments to it.
• Para. 6: If you are in arrears, you cannot switch insurer as long as premiums, co-payments, default interest and debt enforcement costs are outstanding. If you only have arrears for your children, you may still switch.
• Para. 7: Cantons can keep a list of insured persons in arrears; for these people, the insurer suspends the payment of costs except in emergencies.
• Para. 7bis: Once you have come of age, you can switch at the end of the year despite arrears from the time you were a minor.

The details are set out in the Health Insurance Ordinance (KVV): Art. 105a KVV sets default interest at 5% a year. Art. 105b KVV requires the demand for payment at the latest three months after the due date and only allows administrative fees if the insurer provides for them in its rules. Art. 105c KVV prohibits offsetting benefits against unpaid premiums. Art. 105l KVV provides that you are considered to be in arrears from the time the reminder is served, and that a notice of cancellation has no effect if the amounts for which reminders were sent up to one month before the end of the notice period have not been paid in full by the end of that period.

For children, Art. 61a KVG specifies that the premiums are owed exclusively by the parents until the end of the month in which the child comes of age; Art. 64 para. 1bis KVG says the same for the co-payment. Debt enforcement against the adult child for these amounts is null and void.

In supplementary insurance, Art. 20 ICA applies: the insurer sends a reminder with a 14-day deadline. If the reminder is unsuccessful, its obligation to pay benefits is suspended from the end of that deadline. Under Art. 21 ICA, the contract is deemed to be dissolved if the insurer does not take legal action to collect the premium within two months of this deadline.

Example: three unpaid premiums in Bern

Jonas, 36, lives in the city of Bern and has basic health insurance with a CHF 2,500 deductible. As the monthly premium we take the median of all offers in Bern: CHF 482.70 (premiums 2026, municipality of Bern, region 1, adults, with accident cover; source FOPH). Jonas does not pay the premiums for January, February and March 2026.

What this means for you

The most important rule: act early. The longer arrears last, the more interest, fees and debt enforcement costs are added, and the longer you are tied to your insurer.

• Talk to your insurer: Ask for a payment plan before debt enforcement starts, and get the arrangement confirmed in writing.
• Check premium subsidies: If the premium is more than your budget can handle, you may be entitled to a premium subsidy. The canton pays it directly to your insurer.
• Look for a lower premium: The premium calculator shows how much you would save with a different insurer, deductible or insurance model. However, you can only switch once the arrears have been paid.
• Keep an eye on deadlines: To switch on 1 January, amounts for which you received reminders must be paid by 31 December. All dates are listed under deadlines.
• Keep submitting bills: Your insurer may not offset benefits against premiums. So keep submitting doctors’ bills.
• Do not forget supplementary insurance: There, the obligation to pay benefits is already suspended 14 days after the reminder. You pay for treatment during this time yourself.

Common mistakes

• Ignoring reminders. From the reminder on, you are in arrears and switching insurer is blocked. Leaving letters unopened does not change that.
• Believing your insurer will cancel basic health insurance. It is not allowed to. The debt remains and the insurance continues.
• Thinking a certificate of unpaid debt clears your debt. The canton pays the insurer 85%, but your debt remains until it is paid.
• Paying too late and cancelling anyway. If the money only arrives in January, the cancellation at the end of the year has no effect.
• Passing children’s debts on to the child. Parents owe premiums and co-payments until the child comes of age. Debt enforcement against the child for these amounts is null and void.

You can find independent information on insurers and their key figures under health insurers. How we analyse premiums is explained under How we calculate.