Supplementary insurance guide
Supplementary insurance with a pre-existing condition: what is possible
A pre-existing condition does not automatically mean supplementary insurance is no longer possible. The four admission decisions, the duty of disclosure, the rules on reservations — and why the order of steps when switching is decisive.
Last updated on September 8, 2026 · Reviewed by our FINMA-licensed advisory team
In brief
Supplementary insurance is governed by the VVG — insurers decide freely on admission, with four possible outcomes: acceptance without restriction, acceptance with a benefit reservation, acceptance with a premium surcharge, or rejection. A pre-existing condition therefore does not automatically lead to rejection — which outcome is realistic depends on the condition, the product and the insurer, and each insurer assesses applications independently.
Two rules provide firm ground: the health questions must be answered completely and truthfully (VVG Art. 4) — and an existing supplementary insurance policy enjoys statutory protection: ordinarily, it can be cancelled only by the insured person (VVG Art. 35a Abs. 4). Hence: only cancel the existing policy once the new acceptance has been confirmed in writing.
This page provides general information and does not replace personal advice. As of 2026, without guarantee. Admission practice depends on the insurer and product — the applicable contractual conditions and the specific admission decision are decisive.
The starting point: freedom of contract instead of an acceptance obligation
In basic insurance, your state of health plays no role — admission is guaranteed and there are no health questions (acceptance obligation as a licensing requirement, KVAG Art. 5 Bst. i). With supplementary insurance it is the other way round: these are private-law contracts under the VVG, and freedom of contract applies. The insurer may ask about your state of health and assess the application on that basis.
For people with a pre-existing condition, this initially means only one thing: the outcome is open. Between acceptance without reservation and rejection lie two intermediate stages that play a major role in practice — the benefit reservation and the premium surcharge.
How supplementary insurance works in principle is explained in the overview guide →
The four possible outcomes in detail
The Federal Office of Public Health (BAG) states that supplementary insurers may reject applications, exclude benefits and charge risk-based premiums. This results in four possible decisions:
| Decision | What it means |
|---|---|
| Acceptance without restriction | The contract applies on the ordinary terms — the pre-existing condition did not influence the decision. |
| Benefit reservation | The contract applies, but benefits connected with the named condition are excluded — for a limited or an unlimited period. The rest of the cover applies in full. |
| Premium surcharge | The contract applies with the full scope of benefits, but at a higher, risk-adjusted premium. |
| Rejection | The application is not accepted. Since each insurer assesses applications independently, rejection by one insurer does not rule out acceptance by another. |
The duty of disclosure: complete and truthful
The health questions in the application must be answered completely and truthfully — facts that are expressly asked about are deemed material by law (VVG Art. 4). This applies especially with a pre-existing condition: a concealed diagnosis can bring the contract down years later if the insurer learns of it — cancellation within four weeks of learning of the breach, and refusal of benefits for causally influenced losses (VVG Art. 6).
A correctly declared pre-existing condition leads, at worst, to a reservation, a surcharge or a rejection — a concealed one puts the entire contract at risk. The wording of the questions is decisive: what is not asked need not be disclosed on your own initiative.
Reservations: how long they can apply
In individual supplementary health insurance, a benefit reservation may be limited or unlimited in time — the VVG sets no statutory maximum duration here. What is required is transparency: what is excluded, and for how long, must be clearly stated in the contract documents.
This is not to be confused with daily allowance insurance under the KVG, where reservations lapse after five years at the latest (KVG Art. 69 Abs. 2), or with occupational pension provision (OR Art. 331c) — neither of these five-year rules applies to supplementary health insurance.
Whether a specific reservation is limited in time is stated in the policy or in the admission decision — if in doubt, have the insurer confirm in writing exactly what the reservation covers.
Protecting existing cover: the order of steps
An existing supplementary insurance policy is valuable — it enjoys statutory protection: the insurer may cancel it neither ordinarily nor in the event of a claim; only the insured person holds that right (VVG Art. 35a Abs. 4). A contract that has been given up, by contrast, only comes back through a new application including a new health check.
This leads to the order of steps that the Federal Office of Public Health (BAG) also sets out: first submit the application to the new insurer, wait for the written admission decision and review it — and only then cancel the existing policy. Since admission practice differs considerably by insurer and product, a close look at the specific situation is worthwhile.
Frequently asked questions
Can I still get supplementary insurance with a pre-existing condition?
It is possible — the outcome is open. Insurers may accept without reservation, apply a benefit reservation, charge a premium surcharge or reject; each assesses applications independently, and practice differs by condition, product and insurer (source: BAG, VVG).
Do I have to declare my pre-existing condition in the application?
Yes, insofar as it is asked about: the health questions asked must be answered completely and truthfully (VVG Art. 4). False statements can bring the contract down later and cost you benefits (VVG Art. 6) (source: VVG).
What exactly is a benefit reservation?
A contractual exclusion: benefits connected with the named condition are not insured; the rest of the cover applies in full. The reservation must be clearly stated in the contract documents (source: VVG practice, archived supervisory FAQ).
Does a reservation apply forever?
It can: for individual supplementary health insurance, the VVG sets no statutory maximum duration — reservations may be limited or unlimited in time. What matters is what the admission decision and the policy say (source: VVG).
Can the insurer cancel my existing supplementary insurance because I have fallen ill?
No. In supplementary health insurance, the insurer waives by law the ordinary right of cancellation and the right to cancel in the event of a claim (VVG Art. 35a Abs. 4). Breaches of contract, such as a breach of the duty of disclosure, remain reserved (source: VVG).
Cancel first, or submit the new application first?
The application comes first: only cancel the existing supplementary insurance once acceptance by the new insurer has been confirmed in writing and on known terms — this is also the guidance of the BAG. A contract that has been given up only comes back through a new health check (source: BAG).
Does an illness that has fully healed also count as a pre-existing condition?
The wording of the health questions is decisive — many ask about treatments or complaints within specific periods. What falls within the period asked about must be declared, even if it has healed; what is not asked need not be disclosed on your own initiative (VVG Art. 4) (source: VVG).
Sources
- Fedlex — VVG Art. 4, 6, 8 und 35a (duty of disclosure, consequences, protection of existing policies)
- Fedlex — KVAG Art. 5 (acceptance obligation in basic insurance as a licensing requirement)
- BAG — Supplementary insurance (health check, rejection, risk-based premiums)
- Fedlex — KVG Art. 69 (five-year limit only in daily allowance insurance)
- Ombudsstelle Krankenversicherung (neutral point of contact in the event of disputes)
Every deadline and figure on this page has been verified against the official sources linked above. As of the date shown at the top. This page does not replace individual advice.
Advice
Discuss your situation?
You have a pre-existing condition and are wondering what your options are? Get in touch with us — we will gladly look at your situation with you, personally and with no obligation.