Css attributes

CSS must refund premiums to additional insured persons

129 million francs

CSS must refund premiums to additional insured persons

The Swiss Financial Market Supervisory Authority (FINMA) is forcing CSS Insurance to reimburse CHF 129 million to additional policyholders.

The CSS health insurance fund has to reimburse exorbitant premiums to additional insured persons. It was ordered by the financial market supervisory authority FINMA. She justifies this by a serious violation of the law of surveillance. These are bonuses worth 129 million francs.

“Following an on-site inspection, FINMA intensified the supervision of CSS’s supplementary health insurance business in the summer of 2019 and has now completed it,” the Federal Supervisory Authority said on Tuesday. financial markets in a press release. “The CSS is currently analyzing the decree in detail and considering how to proceed,” the CSS said.

General assignment checked

FINMA has therefore examined the general distribution of administrative costs at the expense of supplementary insurance. The investigation revealed that the indirect costs, that is to say for the internal work carried out in favor of the supplementary insurance, were not correctly attributed, according to the press release, to the initiator.

Despite warnings from internal auditors, CSS became dependent on an insurance brokerage firm. According to FINMA, “In the years 2012 to 2014, you paid certain commissions that were not financially justified.” In addition, CSS levied a tax on all commission payments made by the group for the supplementary insurance business from 2018. Due to improper allocation by CSS, undue administrative costs were included in the calculation of the tariff at the time.

who receives money

In addition: FINMA’s decision does not affect the operational activities of CSS. Policyholder claims are protected and solvency rules are complied with. FINMA’s decision is not final and the CSS can be appealed to the Federal Administrative Court.

Holders of supplementary health insurance who took out supplementary health insurance with CSS Versicherung AG between January 1, 2013 and December 31, 2019 receive a premium refund. In individual cases, the amount will depend on the type of product, the duration of the contract and the individual premium amount. According to the CSS, 129 million represents around 1.5% of the average annual premium, or on average around 14 francs per year and per insured. (Louis/SDA)