Distinctions that control the review
Definition of the risk
Find whether the clause concerns the occupation, loss of earning capacity, recognised invalidity or another test, which cause is covered and who assesses it.
Nature of the benefit
Separate recurring income, capital, payment of premiums and continuation of other guarantees. Premium waiver is not necessarily income, and an income benefit does not automatically preserve every component.
Coordination of decisions
Ask whether the insurer relies on a disability-insurance decision or conducts its own assessment and how other benefits are treated. Recognition by one body does not automatically bind all others.
Build a factual file
The file should explain the contract and circumstances without diagnosing or forecasting the outcome.
Definitions and exclusions
Save clauses on occupation, cause, any degree, exclusions, notification and medical or professional evidence requested.
Benefits and premiums
Ask in writing which benefit is assessed, how premiums are handled while it is reviewed and which protection remains under each decision.
Competent channels
Prepare separate approaches to the private insurer, disability insurance, pension fund, employer or accident insurer with one factual chronology.
Keep dated evidence
Archive the policy, conditions, insurer's written response and federal source consulted so the version underlying a later decision remains traceable.
Medical and legal caution
- This page gives no diagnosis, determines no degree and confirms no entitlement.
- No benefit amount, waiting period, payment duration or contractual threshold is generalised.
- Premium waiver must be written in the policy and is not implicit in all life insurance.
Verified Swiss federal sources
FINMA and FSIO guidance is linked in verified English. Fedlex is intentionally linked to the official French Insurance Contract Act because no authoritative English legal text is asserted here. Official texts, the policy and competent decisions prevail.
- OFAS — Invalidity: benefits and contributionsEnglish · Legal concepts of invalidity and incapacity to earn, the different insurance channels involved and their distinct entitlement conditions.↗
- Fedlex — Loi fédérale sur le contrat d'assurance (official French text)French fallback · Official French consolidated text covering pre-contractual information, the contract, life-insurance beneficiaries and statutory rights or notices; no authoritative English text is asserted.↗
- FINMA — Individual life insuranceEnglish · Supervisory framework for individual life insurance, no general approval of rates and specific requirements for surrender values.↗
- FINMA — You have a problem with your insurance companyEnglish · First approaching the insurer, possible review of conversion or surrender values and limits of FINMA's role in private-law disputes.↗