Suva wants detectives back
Following a ruling by the European Court of Justice, Suva dispensed with detectives to uncover cases of fraud. Now, with a new law, it wants to ensure that insurers are once again allowed to use detectives if there are reasonable grounds for suspicion.
On October 18, 2016, the European Court of Human Rights (ECHR) reprimanded the use of detectives to observe insured persons. According to the ruling, Switzerland does not have a sufficient legal basis for this.
In response, Suva has discontinued its ongoing observations and refrained from new assignments. Observation documents from ongoing cases are destroyed, as are medical assessments based on film footage.
Suva wants swift law
Now, however, Suva wants to ensure that the corresponding legal basis is created. To this end, it has already submitted its own proposal for a legal article on the subject of monitoring. This regulates, among other things, which conditions permit monitoring and where it may take place.
The political will is also there on the part of the federal government: The Federal Social Insurance Office (FSIO) has already announced that it will send a corresponding revision of the law for consultation by the end of the year. In addition, the Commission for Social Security and Health of the Council of States (SGK-S) decided last week to also prepare a draft law, which in the quickest case could be passed by parliament in the fall of 2017.
Tighter controls
In order to be able to continue to combat abuse in a targeted manner until a clear legal basis comes into force, Suva says it wants to monitor conspicuous cases more intensively: More medical examinations, increased cooperation with the authorities and more interviews with witnesses are intended to provide clarity at an early stage.
In addition, it wants to carry out more frequent checks with the field staff if there are reasonable grounds for suspicion. This happens especially when an accident victim works according to indications, although he is on sick leave. "We are still doing everything we can to uncover abuse," says Roger Bolt, Suva's team leader for combating abuse. "For us, it is central that we can handle the premium money entrusted to us dutifully and only provide benefits to insured persons who are entitled to them." However, there will always be expensive individual cases that can only be prevented thanks to detectives.
With material from Suva
