Portability clause in daily sickness benefits insurance

Purpose

If an employed person covered under an employer’s group daily sickness benefits policy under the VVG loses their job and subsequently qualifies as unemployed under the Unemployment Insurance Act, group cover generally ends as well. The portability clause secures that person’s statutory right to move into an individual policy with the same insurer without a new health assessment and without new policy reservations, so no coverage gap arises and an already-elevated risk does not lead to exclusion.

Effect and limits

The insurer must notify the person in writing of the right to transfer; if it fails to do so, the person remains covered under the group policy. Once notified, the transfer must be requested within three months. The new individual policy may not exceed the previous group cover in scope, but is priced at the insurer’s ordinary individual rates, which can be considerably higher than the pro-rata group premium. Individuals who move directly to a new job rather than becoming unemployed have no statutory claim of this kind; any right of transfer then depends solely on the general conditions of the group policy.

Negotiation and practice

For employees, it is critical not to miss the three-month transfer window; HR departments and social counselling services should ideally flag this right proactively on termination, even though the formal duty to inform rests with the insurer. Because individual cover is more expensive than the group rate, anyone moving directly between jobs should compare it against a new employer’s scheme, provided continuity of cover is secured under the applicable conditions. The statutory right of transfer on unemployment is anchored in Art. 100 para. 2 VVG together with Art. 71 KVG as a mandatory minimum guarantee.