[Private accident insurance in Switzerland with reference to liability insurance as a part of social security]. / Die private Unfallversicherung in der Schweiz unter Berücksichtigung der Haftpflichtversicherung als Bestandteil der sozialen Sicherheit.

On the Swiss market there exist various different accident insurance schemes and systems. Private accident insurance which is offered by the private insurers, date back to the middle of the 19th century. Since 1912 accident insurance is compulsory for all employees working in particularly dangerous industries, since 1984 it covers all employees in the country. In Switzerland there exists no general compulsory accident insurance. To perform as insurance carriers are qualified: private insurance companies, the Swiss Accident Insurance Company, and a number of the social health (sickness) insurers. Depending on the insurance system there are different approaches to renumerate the health costs. In the various social insurance systems the patient is rather free to chose his doctor and hospital (among those who have a contract with the insurer); in private insurance he is completely free. Yet the billing systems and the applicable rates and tarifs differ considerably. There are trends to simplify these systems and bring them more into mutual accordance. Due to the important rise of the health costs in Switzerland, there exists the danger that possible simplifications will bring about more public influence yet less private initiative and less incentives to really control costs without lessening the patients' possibilities.

[The covering physician system from the viewpoint of the insurance company]. / Das Belegarztsystem aus der Sicht der Versicherer.

The main question is: To whom and according to which regulations does the nonresident physician bill for reimbursement? The analysis brings to evidence, that different answers have to be given for each kind of treatment (outpatient medicine, care in ambulatory settings of hospitals, and inpatient medicine). Moreover, each kind has to be looked at differently with regard to three categories: (1) the patient who pays himself (self payers scheme), (2) the patient who is subject to the social illness insurance, and (3) the one is subject to the compulsory social accident insurance. The whole matter is extremely complex, and thus little understood as well by the nonresident physician as by the patients. Furthermore, economic disparities are apparent when looking at the various social insurance legislations, and when considering the medical tariff of each social insurance scheme. Obviously, the self payer schemes are simple, transparent and thus better understood: The nonresident physician bills to the patient directly, who in term owes payments, regardless whether he is insured or not. This system applies to all non-social insurance schemes, particularly to the private insurance scheme. Yet, the self payers schemes are successful only when State and local governments reduce their subsidies and grants to their own hospitals, and if all medical services are paid on an effective cost basis: in order to give equal chances to all medical services, private and public. Thus, the patients' position would be uprated. At the same token, the nonresident physicians would have firmer chances which in turn would mean an enormous advantage to their patients since they could be treated by one and the same physician before, during and after their hospital stays.

[Shaft fractures in childhood. Insurance problems from the viewpoint of liability]. / Schaftfrakturen im Kindesalter. Versicherungsfragen unter dem Haftpflichtaspekt.

Childhood accidents of any kind do not present any particular problems to Swiss third party liability insurers. However, such claims call for an active handling by the claims adjusters as well as intense contacts between claims adjuster, responsible physician, and parents in order to prevent any long term complications.