21 January 2026

tarifsuisse Ltd, acting on behalf of 23 health insurance funds, initiated legal proceedings before the Arbitration Tribunal for Social Insurance Disputes of the Canton of Zurich against A. Ltd. tarifsuisse Ltd sought reimbursement of CHF 375,042, alleging that A. Ltd had unlawfully operated laboratories. The cantonal Arbitration Tribunal upheld the claim and ordered A. Ltd to reimburse the amount claimed. A. Ltd subsequently lodged an appeal with the Federal Supreme Court, which dismissed the appeal.

A. Ltd argued, inter alia, that the services provided had been rendered lawfully. The Federal Supreme Court rejected this argument, noting that A. Ltd had failed to sufficiently substantiate that the persons concerned held the required qualifications. The Federal Supreme Court also dismissed A. Ltd's reliance on the principle of the protection of legitimate expectations. With regard to the legal basis for the reimbursement claim, A. Ltd contended that Art. 56 para. 2 of the Swiss Federal Law on Health Insurance (Bundesgesetz über die Krankenversicherung, KVG), contrary to the view taken by the cantonal Arbitration Tribunal, was not applicable in the present case. The Federal Supreme Court left open the question of the applicable statutory basis in the specific individual case. However, it concluded that a statutory basis existed, and that a legal basis for the claim was therefore established. Finally, A. Ltd invoked the forfeiture of the reimbursement claim, which was likewise rejected by the Federal Supreme Court.

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