Distinctions that control the next step
Identify the policy's legal basis
Look for LAMal or LCA in the policy, terms and correspondence. The FOPH distinguishes two systems whose rules are not interchangeable.
Read contract parameters
Record insured earnings, any benefit start, duration, exclusions, reservations and coordination exactly as written, without turning a contract value into a payment promise.
Choose the competent contact
The insurer should explain its position. Supervision, mediation and court routes depend on the regime; FINMA does not decide private disputes or administer social LAMal insurance.
Verify the route in four steps
Identify the system, documents already held and competent body before drawing a conclusion; sensitive material remains in that body's official channels.
Identify the policy's legal basis
Look for LAMal or LCA in the policy, terms and correspondence. The FOPH distinguishes two systems whose rules are not interchangeable.
Read contract parameters
Record insured earnings, any benefit start, duration, exclusions, reservations and coordination exactly as written, without turning a contract value into a payment promise.
Choose the competent contact
The insurer should explain its position. Supervision, mediation and court routes depend on the regime; FINMA does not decide private disputes or administer social LAMal insurance.
Obtain written confirmation
Contact the competent employer, insurer, AI office or pension institution directly and use only its secure channel.
Limits and essential checks
- Comparing health-insurance premiums does not compare income protection or predict acceptance under an LCA policy.
- General information only: no incapacity is assessed automatically and no diagnosis is made.
- No entitlement, amount, deadline, rate, acceptance or contract change is promised; only the competent body may decide under the applicable rules.
- ClairAssur is not a reporting channel: do not send documents, health data, diagnoses, claim numbers or free-text case descriptions here.
Official sources
Sources are shown in an available official language; the current text and the competent body's decision prevail.
- OFSP — Assurance facultative d'indemnités journalièresOfficial French · Distinction officielle entre les régimes LAMal et LCA et leurs principes généraux.↗
- Fedlex — Loi fédérale sur l'assurance-maladie (LAMal)Official French · Texte fédéral consolidé du régime social, dont l'assurance facultative d'indemnités journalières.↗
- Fedlex — Loi sur le contrat d'assurance (LCA)Official French · Texte fédéral consolidé applicable aux contrats d'assurance privés; les conditions contractuelles restent déterminantes.↗
- FINMA — Vous avez un problème avec votre assuranceOfficial French · Rôles de l'assureur, de la surveillance, de la médiation et des tribunaux selon le type de différend.↗