Double health insurance after switching: who pays, what to do?

Two policies, but only one basic health insurance

After changing health insurer, you sometimes find two policies or two premium invoices in your letterbox in January. This looks like double insurance, but in basic health insurance it never is. The law states that the old insurance only ends once the new insurer has notified the old one that you are insured with it without interruption (Art. 7 para. 5 of the Federal Health Insurance Act, KVG). So there is always exactly one responsible insurer, never two and never none.

It is different for supplementary insurance and accident cover. There, the same cover can actually exist twice, and you pay two premiums for a loss that is reimbursed once at most.

Why there is no double insurance in basic health insurance

The switch takes place in two steps. You cancel with the old insurer and register with the new one. The new insurer then sends the old one notification that you are insured with it without interruption. Only with this notification does the old insurance relationship end, and the old insurer must tell you from when you are no longer insured with it (Art. 7 para. 5 KVG). This letter is the confirmation of cancellation.

If one of the steps fails, the old insurance simply continues. Registering with the new insurer then does not create a second contract for the same period. This protects you from a gap: you are never without basic health insurance, even if something goes wrong with the switch.

The three most common reasons why the switch fails:

• The notice of cancellation arrived too late. To switch on 1 January, it must reach the old insurer by 30 November; what counts is receipt, not the postmark (Art. 7 para. 2 KVG). The Federal Office of Public Health (FOPH) recommends sending it by registered mail or A-Post Plus by 15 November.
• The new insurer did not send the notification. Then it bears the consequences (see below).
• Premiums with reminders are outstanding. If you have not paid in full premiums, co-payments, default interest or debt enforcement costs for which you received a reminder, you cannot switch (Art. 64a para. 6 KVG). The old insurer must inform the new one within 60 days that you remain insured with it (Art. 105l para. 3 KVV).

Step by step: how to sort out two invoices

1. Look for the confirmation of cancellation. Has the old insurer given you an end date in writing? If so, the new insurer is responsible from that date and the new invoice is correct. If there is no confirmation, you remain insured with the old insurer until further notice.
2. Prove when your notice arrived. Have the tracking for the registered letter or the A-Post Plus item ready. It shows whether the notice of cancellation arrived by 30 November.
3. Ask the old insurer in writing. Ask whether it received the notification from the new insurer and until when you are insured with it. Request the answer in writing.
4. Inform the new insurer. If the switch failed, inform the new insurer in writing that you remain insured with the old one. Ask it to postpone your registration to the next possible date or cancel it, and to refund any premiums already paid.
5. Only pay the correct premium. Pay the invoice from the insurer you are actually insured with. If premiums for the old insurer remain unpaid because you thought the matter was settled, a reminder and a demand for payment will follow, and your next switch will be blocked.
6. Check your health insurance card. At the doctor’s, pharmacy and hospital, show the card of the insurer you are insured with on the day of treatment.
7. Note the next date. The deadline calculator shows the next possible date for switching and the day by which your notice of cancellation must arrive.

Who pays medical bills during the transition?

For the deductible and the retention fee, the date of treatment counts (Art. 103 para. 3 KVV). The insurer you had basic health insurance with on that day covers the invoice. An invoice for treatment in December therefore belongs to the old insurer, even if it only arrives in February. Treatment from 1 January belongs to the new insurer, provided the switch worked.

If you send an invoice to the wrong insurer, it will not be paid. Forward it to the responsible insurer with a short note saying from when you are insured there. The benefits of basic health insurance are the same at all insurers, so you do not lose any entitlement when you switch.

If, exceptionally, you switch during the year, for example with effect from 30 June, the new insurer credits the deductible and the retention fee already invoiced in the current year (Art. 103 para. 4 KVV). So you do not pay the deductible twice.

If the new insurer forgot to send the notification

If you cancelled and registered on time but the new insurer does not send the notification, you formally remain with the old insurer. The law places the consequences on the new insurer: it must compensate you for the resulting loss, in particular the difference in premium (Art. 7 para. 5 KVG). Conversely, if the old insurer prevents the switch, it owes you compensation (Art. 7 para. 6 KVG).

If the insurer you have chosen does not respond to your registration, the FOPH recommends sending it your application for basic health insurance, with the deductible and start date you want, by registered mail or A-Post Plus. That way you can later prove that you did everything necessary.

Example with fictitious people.

If you get nowhere with the new insurer, the Office of the health insurance ombudsperson mediates between you and the insurer free of charge.

Double supplementary insurance: what the ICA says

With supplementary insurance, real double insurance can easily arise. A typical case: you switch basic health insurance, take out supplementary hospital or outpatient insurance with the new insurer at the same time and forget that the old supplementary insurance continues. The old insurer does not cancel it on its own initiative, because it may not do so because you switched basic health insurance (Art. 7 para. 8 KVG).

The Insurance Contract Act (ICA) calls this multiple insurance and regulates it as follows:

• Duty to notify: You must report the multiple insurance to all insurers without delay, in writing or by email (Art. 46b para. 1 ICA).
• Right to cancel: If you did not know about the overlap when you took out the later contract, you can cancel it within four weeks of discovering it (Art. 46b para. 2 ICA).
• Benefits: Each insurer is only liable proportionally; you are reimbursed for the loss once at most (Art. 46c ICA).
• Premium: Each insurer is entitled to the full agreed premium (Art. 46b para. 4 ICA).

Outside this special right, the ordinary cancellation rules apply. Under Art. 35a para. 1 ICA, you can cancel a contract with effect from the end of the third or any subsequent year with three months’ notice; the contract may provide for shorter periods. In supplementary health insurance, only you have the ordinary right to cancel, not the insurer (Art. 35a para. 4 ICA). What counts is the general terms and conditions and the information from your insurer.

Double accident insurance: exclude accident cover

If you work at least eight hours a week for the same employer, you are also insured against non-work-related accidents through your employer under the Accident Insurance Act (UVG). The accident cover of your health insurance then hardly ever comes into play. You can have it excluded and save on premium (Art. 8 KVG). If you lose or leave your job, you must include it again. You can work out whether and how much this saves in the exclude accident cover tool.

Special cases

• Moving to a region where your insurer does not operate. If you have to leave your insurer because of a move, the insurance ends when you move away (Art. 7 para. 3 KVG). Register with the new insurer from the same date; then there is neither a gap nor an overlap. If your new municipality requires proof, the new insurer issues you a confirmation of insurance.
• Children. The same switching rules apply to children. If there are arrears with reminders for a child, the child cannot switch insurer (Art. 64a para. 6 KVG).
• Switching on 1 July. This is only possible with the standard deductible of CHF 300 in the standard model, with the notice of cancellation received by 31 March (Art. 7 para. 1 KVG; Art. 94 para. 2 and Art. 100 para. 3 KVV).

Common mistakes

• Paying both invoices. Only pay the insurer you are actually insured with, and have the other refund any premiums you overpaid.
• Ignoring the old invoice. As long as the switch has not been confirmed, the old insurer’s premiums remain due. Once a reminder has been sent, your next switch is blocked.
• Sending the notice of cancellation by A-Post in the last week. The postmark does not count, only receipt by 30 November. You can create the letter with the cancellation letter generator.
• Forgetting the old supplementary insurance. It continues even if you have switched basic health insurance. After switching, check all policies side by side.
• Not claiming compensation. If the new insurer missed the notification, claim the difference in premium in writing.

The overview Switching health insurer shows how to make a switch run smoothly from the start. The article Notice of cancellation too late explains what you can do if your notice arrived too late. What happens to ongoing treatment is covered under Switching during treatment. You will find key figures and contact details for the insurers in the health insurer profiles, and all articles on the topic in the topic area Switching health insurer.