Federal Supreme Court, Decision 9C_511/2020 of 13 January 2021
5 février 2021 – In this decision, the Federal Supreme Court had to decide on a health insurance case regarding mental symptoms of Huntington's disease. A patient covered by mandatory health care insurance suffered from Huntington's disease and bruxism. Diagnosed with severe chronic periodontitis, the treating dentists submitted a request to the health insurance company for coverage of various treatments including various caries treatments, oral hygiene instruction, periodontal therapy and an adjustment of the existing prosthesis. The health insurance company rejected the request. Now the Federal Court rejected the patient's appeal. It supported the lower court in its view that the illness does not fall under the concept of “severe mental illness with consecutive severe impairment of the chewing function” according to Art. 18 lit. c (7) Health Care Benefits Ordinance (KLV). In the case of Huntington's disease, which is mild to moderately severe, bruxism does not require the assumption of the costs of treatment by compulsory health insurance.
For the full decision, see here.