Art. 27 Loi portant introduction de la loi fédérale sur l’assurance-maladie (LiLAMal)

ARMP.2024.62 · ne (Art. 27 LAMal)

Insured vs. Health Insurer: Congenital Infirmity Orthodontic Coverage After Disability Limit

This article was used extensively in the reasoning to define the coordination between health insurance and disability insurance for congenital conditions, although the final order accepted the appeal on procedural grounds related to the continuation of treatment.

VG.2022.00045 · gl (Art. 27 KVG)

Home Nursing Care Coverage for Cystic Fibrosis Patient

Cited as the basis for the health insurance's liability for services not covered by disability insurance in cases of congenital defects.

36.2021.50 · ti (Art. 27 LAMal)

Hydrocele Surgery Inpatient Coverage Appeal Denial

Cited in the reasoning section regarding the scope of covered services.

C-1194/2017 (art. 27 LAMal)

Swiss resident not eligible for Swiss disability benefits for congenital condition.

Cited as the legal basis for health insurance to cover costs of congenital malformations not covered by AI.

A/3402/2019 · ge (art. 27 LAMal)

Insured v. Mandatory Health Insurance (Severe Craniofacial Asymmetry Coverage)

This provision on congenital infirmities was discussed as the basis for coverage in relation to disability insurance coordination.

VSBES.2017.182 · so (Art. 27 KVG)

Policyholder v. Health Insurer (Cystic Fibrosis Medication Coverage)

Cited in the reasoning as the provision stating that for congenital disorders not covered by IV, the mandatory health insurance covers the same benefits as for illness.

KV.2017.14 · bs (Art. 27 KVG)

Cochlear Implantation Coverage Liability: Health Insurance vs. Disability Insurance for Congenital Deafness

Used as the basis for finding the respondent subsidiary liable for the costs of the cochlear implants due to the lack of IV coverage for a congenital defect.

AM.13.15.60.2016 · vd (Art. 27 LAMal)

Insured Individual v. Health Insurance Provider: Coverage for Congenital Disorder Medication Post-Disability Benefits

Cited in the header, supporting the basis for the claim regarding coverage for congenital infirmities under mandatory health insurance.

608 2015 151 · fr (art. 27 LAMal)

Disability Insurance Coverage for Autism Treatment Retroactivity and Necessity

Cited to establish that health insurance covers costs for congenital infirmities not covered by disability insurance.

A/216/2014 · ge (Art. 27 LAMal)

Insurer Appeal on Denial of Coverage for Infant's Pyelocalyceal Dilatation

Cited to establish the standing of the insurance company to appeal against the negative decision (Point 3).

36.2010.107 · ti (art. 27 LAMal)

Insured Party v. Administrative Decision on Default Interest and Expenses for Foreign Spectacle Reimbursement

Cited in the discussion on the scope of compulsory health insurance benefits, which forms the basis for the partial success of the appeal concerning interest.

S 09 544 · lu (Art. 27 KVG)

Health Insurer Obligation to Cover Congenital Defect Medication Without Prior Disability Payments

The court considered this article as a basis for the health insurer's liability regarding benefits for birth defects.

AM.70.08.40.2009 · vd (Art. 27 LAMal)

Health Insurer Refuses Coverage for Post-Age-20 Speech Therapy

Cited as the provision governing the continuation of coverage by health insurance after disability insurance coverage ends, which was assessed in denying coverage.

IV.2005.00465 · zh (Art. 27 KVG)

Disability Insurance Coverage for Congenital Heart Condition Upheld

This provision, cited alongside Art. 70 Abs. 2 lit. a ATSG, is relevant for the principle of reimbursement of advance payments made by the health insurer.

IV.2005.00465 · zh (Art. 70 Abs. 2 lit. a ATSG in Verbindung mit Art. 27 des Bundesgesetzes über die Krankenversicherung, KVG)

Insurer Appeal on Congenital Condition Coverage Denial

Cited in the reasoning (Erw. 3.2) as the basis for the appellant's right to reimbursement for advances made, which is covered by the partial approval of the appeal in order 1.