Federal Supreme Court, Decision 9C_265/2019, of 18 February 2020

12. März 2020 – In a recent decision, the Federal Supreme Court held that the assumption of emergency treatments abroad within the framework of assistance in kind provided in Article 36 Para. 2 KVV is also applicable to people who are exempt from mandatory insurance in Switzerland and who receive medical treatment in a country that is not a contracting party to the Agreement of 21 June 1999 between the Swiss Confederation and the European Union and its Member States. All of this under the assumption that there is an emergency. Contrary to the view of the lower court that Regulation No. 883/2004 and the temporary assistance provided for therein are limited to the internal European relations of the contracting states, the Federal Supreme Court held that Regulation No. 883/2004 does not contain any explicit provision on its territorial scope. The Federal Supreme Court stated that the fact of having been treated outside the territory of the Member States does not justify the exclusion of the Regulation from application. In addition, the Federal Supreme Court adopted the practice of the European Court of Justice and stated that a person who is covered by health insurance in one Member State is entitled to claim health insurance benefits under the system in any other Member State in which he or she resides. The Federal Supreme Court concluded that the assumption of the costs of emergency treatment abroad within the framework of assistance in kind provided for in Article 36 para. 2 KVV is in principle also applicable to the complainant, a Dutch national, who is not mandatorily insured in Switzerland. The appeal was rejected to the defendant for the purpose of assessing whether emergency circumstances existed.