Here is yet another cautionary (and boring) tale about the long, bureaucratic, and deeply annoying process of trying to deal with crummy people and organizations in Switzerland. This time, it’s about health insurance.

Context

Switzerland does not have a universal healthcare system like France. Rather, everyone* is mandated by law to take out a private health insurance plan. For the vast majority, health insurance is not tied to employment, and it doesn’t get taken out of your paycheck. You choose a company and a plan for yourself, and you pay for it yourself. People who are unemployed or earn low incomes can apply for subsidies from the government that help them offset the costs.

(*Some people are exempt from this requirement, including foreign diplomats and people who work for certain international organizations. The Swiss government has a list here.)

There are some pros and cons to the Swiss system. The pro is that if you are ill, there is a safety net to protect you from expensive medical bills that would drive you to bankruptcy, as often happens in the US. Under my previous insurance plan, the most I would have paid for medical expenses out of pocket each year was CHF 3,200. If I were sick and required very expensive treatment, in theory, everything above that figure would have been covered by my health insurance provider.

Unfortunately, there are many cons. The first is that it’s not universal healthcare. Everyone has a different provider and a different plan. When you visit the doctor, you have to pay for all expenses upfront. Later, you file paperwork to get reimbursed by your health insurance provider.

Second, it’s expensive. My premium was CHF 420 a month for health insurance only. Compare this to the US, where I only paid around USD 30 a month for health, dental, and vision insurance altogether. (I worked for a nonprofit in DC that negotiated very good rates for its employees.) Third, mental health treatment is not covered, as it’s considered a pre-existing condition.

Lastly, many of these Swiss health insurance providers are scummy as hell. Bureaucratic, unresponsive, limited coverage and poor customer service. But I’ll stop here and explain what actually happened.

The story

When I moved to Switzerland in 2019, I went to work for an international organization that was not exempt from the requirement to take out health insurance. My employer at the time had a special arrangement with Company S, which offered us slightly reduced rates. They had a dedicated customer service representative who visited our office premises and spoke perfect English. I had just moved to the country, did not speak French, and was totally overwhelmed by all the new things that were happening, so I got bamboozled. I just signed up with them without doing any research or comparing other providers.

Over the next two years, I was surprised to learn that this insurance provider covered very little of my medical expenses. They refused to cover anything related to my mental health issues. When I had a heart murmur and had to go to the urgent care clinic, they refused to cover that as well. At one point I sat up and was like, “wait a minute — what exactly am I paying these assholes 420 francs a month for?”

(I would not be surprised if this legal requirement to have health insurance had come about as a result of health insurance companies lobbying the Swiss government. We’re forced to take out health insurance from these private companies and forced to pay their inflated prices in exchange for almost nothing in return. It’s pretty demoralizing to think about.)

In the summer of 2021, my lucky break came. I got a new job at an international organization that is exempt from the health insurance requirement.

Upon joining my new organization, I immediately signed up for its private health insurance plan that is available to its employees globally. I asked HR if there was anything they could do to release me from my contract with Company S. No, HR told me. In Switzerland, if you want to cancel a health insurance contract, you have to give notice very far in advance — as in by 30 November the previous year. Then your cancellation will go into effect on the 1st of January the following year.

I would later learn from another person in HR that the first HR representative had been mistaken. As somebody who worked for an international organization and held a residency permit that was 100% tied to my job, the moment I quit my old job and handed back my permit, I was considered to have ‘left’ Switzerland. I should have cancelled my contract right then and there on the grounds that I no longer ‘lived’ in the country.

But I didn’t know this, and instead I kept both health insurances for the rest of the year — yes, paying both premiums. A foolish error that cost me an additional 2,500 francs.

In August, I downloaded a suggested ‘contract termination’ letter template from the Swiss government website, filled it out, and sent it via registered mail to Company S. (Registered mail is when you pay extra to require that someone on the other end signs for the letter; it’s essential for legal communications. Snail mail is very important in Switzerland.) Again, it was August, and the cancellation deadline was November. I figured it was done and dusted.

For the rest of the year, I didn’t hear a peep from Company S.

The new year came and went, and suddenly, in the middle of February, I received a letter from Company S in the mail. “As you know, under Swiss law, it is compulsory to have health insurance,” it said, in essence. “Because you did not send us any proof of your new health insurance plan, we have gone ahead and renewed the health insurance plan that you had with us. Oh, and here’s an invoice for the first two months’ premiums. Now pay up, connard.”

This letter almost triggered my heart murmur again.

I immediately mailed a letter back to Company S, explaining that 1) even though I’m legally not required to have health insurance, 2) as a matter of fact, I do have health insurance. I enclosed copies of statements from my employer attesting to these claims.

I heard nothing from Company S — except to bill me again for March.

I sent another letter, reiterating the same points I’d made in the February letter.

I heard nothing — except to bill me again for April.

I sent another letter to the same effect.

I heard nothing — except to bill me again for May.

By this point, I had spent over 20 francs on stamps alone. (Registered mail is expensive!)

By the end of April, I was apoplectic. Just thinking about this situation made me tense up like an angry porcupine. By this point, Company S was claiming that I owed them over 700 francs in unpaid premiums.

I looked into legal advice. I spent a whole morning searching for English-speaking law firms that work in Switzerland and contacted one. They advised me that they could help me write a letter to Company S — for 250 francs.

Next, I contacted FRC, la Fédération romande des consommateurs. It’s a nonprofit organization in French-speaking Switzerland that helps consumers navigate disputes with companies. To access their one-time legal advice, I had to pay 70 francs to become a member. I did that, and then wrote them a long, despondent message in French about my situation. I told them that I had already sent Company S four (4!) letters by mail with no response. What should I do?

Later that day, FRC emailed me back with a long response.

They advised that I should send Company S another letter.

…………

Okay, I’m not being totally fair here. I think they were somewhat helpful. They gave me the names of the exact legislation that I could cite in my letter to Company S to prove that they were violating the law. And they told me that if the letter continued to be ignored, I could reach out to l’Office de médiation de l’assurance-maladie, which is an Ombudsman based in Lucerne that mediates disputes between consumers and health insurance companies. I had not come upon this service before in my frenzied Googling, so that was good to know.

So yeah, this was the legal advice that I got for 70 francs.

The conclusion (hopefully)

Feeling deeply demoralized, I put together another letter to Company S. But this time, I decided to address it directly to the CEO, because why not. I have seen this hail Mary practice work for people in the US, but as for Switzerland, I had no idea. Again, there was almost nothing else left to try, so what the hell.

I wrote a letter in French, emphasizing that this situation was causing me great stress and anxiety (true) and that I was worried my heart murmur would cause issues again (also true). I enclosed copies of all of the previous letters that I had sent them. I printed these letters out and took them home, where I sealed them in an envelope and planned to toss the letter into the mailbox at my local post office the following day.

Then, the following morning, just before going to the post office, I received an email in my inbox. “We have received your letter from March,” it read, “and can confirm the termination of your contract effective 31 December 2021.” It was already May by that point.

Finally, I thought.

Then the end of May came — and I received another bill.

As well as a letter threatening to report me to the local authorities for failing to pay all of the invoices issued so far.

I immediately printed out a copy of the aforementioned email sent by their employee and mailed it back to them.

The next day, I received a credit to my bank account from Company S, for an amount equivalent to five months of invoice payments. Apparently they were now reimbursing me for the payments that I had refused to make in the first place.

Chaos. Absolute chaos.

Closing thoughts

In conclusion, I guess the takeaways are:

• Know your rights.
• Be annoyingly persistent.
• Keep everything in writing. NO PHONE CALLS.
• Avoid Swiss health insurance if at all possible.

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Photo by Enric Moreu on Unsplash