The Federal Office of Public Health BAG revokes the license of the health insurer KluG. Shady practices and negligence on the part of the regulator come to light.
The Zug-based health insurance company KluG is bankrupt. However, it was not the health insurer itself that filed for bankruptcy.
The supervisory authority for social health insurance, the Federal Office of Public Health (FOPH/BAG), already declared insolvency by order last Wednesday, as the regulator announced today, Tuesday.
Benefits concealed in books
The license to provide basic insurance (KVG) will be revoked on December 31, 2025, it added.
KLuG itself requested both measures, the supervisory authority explained.
KluG announced that it had already submitted the relevant applications at the end of July.
However, the FOPH is also investigating the criminal relevance of the incidents, as the KLuG board recently discovered, following information from the management, that benefits amounting to around 2.4 million Swiss francs had not been recorded in the accounts. The health insurance company was declared insolvent.
Supervision asleep at the wheel
The health insurance company KLuG, based in Zug, has been in a very difficult financial situation for some time.
According to the communiqué, the FOPH has therefore been closely monitoring the health insurance company’s business activities for two years.
The regulator has already taken various measures to restore its financial stability.
Why the supervisory authority did not discover during its audits that KluG had apparently failed to record millions in benefits in its accounts remains to be seen.
Insurance coverage guaranteed
The declaration of insolvency would protect the approximately 9,300 insured persons because it activates the insolvency fund at the Joint Institution of the KVG.
This ensures that the insured persons’ benefits will be reimbursed as soon as KLuG is no longer able to meet all of its obligations.
Market leader Helsana will make an offer to customers for basic insurance.
The industry would also guarantee seamless insurance coverage and reimbursement for supplementary insurance products, explained the FOPH, although the Swiss Financial Market Supervisory Authority (FINMA) is responsible for this area.
Role of supervisory authority unclear
How could KluG have ended up in this situation? Well, for 2024, the health insurance company itself reported a solvency ratio of 119 percent.
However, the BAG came to the conclusion in its own calculations that solvency was only 24 percent. This repored muula.ch on the unusual case, which became known back as early as September 2024.
An increase in premiums during the year was apparently unable to resolve the financial problems, meaning that the supervisory authority must also face criticism for this.
The regulator’s long wait also requires explanation. Even the communiqué on the insolvency reached the public almost a week later.
Glaring abuses
The BAG, under the leadership of Health Minister Elisabeth Baume-Schneider, regularly approves health insurance premiums that are too low, which muula.ch had also already addressed.
Numerous health insurers reported solvency ratios that were below the legally prescribed minimum of 100 percent.
And as it turns out, the KVG solvency test can signal a 19 percent over-coverage of obligations, even though the end is already approaching.
12.08.2025/kut./ena.Report supplemented with information from KluG
