§ 69 Krankenversicherungsverordnung (TG KVV) - Aufsicht

608 2013 45 · fr (Art. 69 LAMal)

Insured v. Health Insurer: Misrepresentation and Timeliness of Rescission

The court implicitly confirms the grounds for the insurance company to institute a reservation based on this article regarding pre-existing conditions, although the main ground for the final order is procedural.

KV.2003.00023 · zh (Art. 69 KVG)

Insurer's Right to Recourse Limited by Procedural Breach Despite Insured's Misrepresentation

The court orders the case to be returned to the respondent to rule on the retrospective reservation, which is the legal consequence derived from the justified violation of the duty to disclose, based on this article.

KV.2003.00023 · zh (Art. 69 KVG)

Claimant v. Insurer: Breach of Disclosure and Scope of Retroactive Exclusion

The court remanded the case for the authority to rule on the retroactive reservation (Vorbehalt) based on the established breach of the duty to disclose, which is regulated under this article.

KV.2001.00056 · zh (Art. 69 KVG)

Refusal to Rule Complaint Dismissed Due to Mootness and Procedural Defects

Although discussed in the reasoning (4.3.2), it is not explicitly cited in the dispositive orders 1-4.

TA.2002.199 · ne (Art. 69 LAMal)

Insured's Failure to Disclose Ongoing Medical Treatment for Undiagnosed Condition Justifies Insurance Reserve

The court applied this article as the substantive legal basis for upholding the retroactive insurance reserve imposed by the insurer.

36.2001.85 · ti (Art. 69 LAMal)

Insured Wins Appeal Against Retroactive Disability Reserve for Concealed Bipolar Diagnosis

The decision to overturn the challenged ruling relies on the court's determination that the conditions for imposing a retroactive reservation under this article were not met, specifically regarding the insured's culpability for non-disclosure.

36.2001.33 · ti (Art. 69 LAMal)

Insurer Upheld in Retroactive Reservation of Daily Allowance Insurance Due to Misrepresentation of Pre-existing Conditions

Although the court decision for appeal rejection (1) does not cite a specific article, the substantive legal basis for upholding the insurance company's decision (imposing a retroactive reservation) is derived from Art. 69 LAMal, which is extensively discussed and applied throughout the reasoning to justify the continuation of the reservation imposed by the insurer.

36.1999.170 · ti (Art. 69 LAMal)

Insured vs. Sickness Insurer: Application of Collective Policy Reserves Upon Transition to Individual Plan

Cited in the reasoning section when discussing the insurer's right to impose reservations, although the application to the final order is indirect via the court's confirmation of the insurer's conduct under this article.

36.1999.170 · ti (art 69 cpv. 2 LAMal)

Insured vs. Sickness Insurer: Application of Collective Policy Reserves Upon Transition to Individual Plan

Cited in the reasoning section regarding the time limit for reservations to lapse.

A/1063/1999 · ge (art. 69 LAMal)

Insured's Health Insurance Reservations Dispute After Employment Gap

The court ruled on the validity of the insurance reserves based on this article.

36.2001.33 · ti (art. 69 LAMal)

Insurer's Right Confirmed to Retroactively Apply Reservation and Reclaim Benefits Due to Claimant's Reticence

Cited in the reasoning as the legal basis allowing insurers to exclude risks upon conclusion of a daily allowance insurance, which underpins the decision to apply a retroactive reservation.

36.2001.90 · ti (art. 69 LAMal)

Insured's Right to Transfer to Individual Insurance with Reservation for Pre-existing Condition

Applied by analogy to justify the insurer's right to place a reservation regarding pre-existing illness in the individual insurance plan after transfer.

36.2002.103 · ti (art. 69 cpv. 1 KVG)

Insured Knowledge of Accrued Risk Precludes Coverage Upgrade Validity

Cited in the reasoning by reference (DTF 127 III 21) regarding the handling of relapses as pre-existing conditions, which supports the argument under Art. 9 LCA.