Imagine a company recording growth of 189% in a year. Excellent news that can turn into a nightmare in the very regulated world of compulsory health insurance in Switzerland. This is what happened to the small Zugoise Klug insurance between 2022 and 2023. It then experienced “exceptional growth in the number of insured, notes the company. This changed our financial situation and led to a huge charge for us. ”
In question, the risk compensation mechanism. It was “created so that insurers are not tempted to ensure as much as possible healthy people,” explains the Federal Office for Public Health (OFSP). A rule that prevents an insurer from chasing the right risks. This compensation allows a financial rebalancing between sickness insurance, as the FOSP explains: “insurers having to face low risks, with a workforce made up of healthy people, pay royalties used to compensate for insurers confronted with high risks.” The massive influx of new insured people at Klug thus forced the company to make “significant early payments” within the framework of this mechanism.
