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HEALTH INSURANCE

WTO worker ‘defrauds’ health insurer of $3.4m

An employee of the Geneva-based World Trade Organization from Uruguay is accused of defrauding his health insurer of three million francs ($3.4 million) over nine years with false medical bills, including treatment for an imaginary cancer.

WTO worker 'defrauds' health insurer of $3.4m
Photo: WTO

The Uruguay man went on trial this week in Nyon, a town in the canton of Vaud near Geneva for sending 2,700 fraudulent documents to justify expenses for medical treatment that he never received, the 20 Minutes newspaper reported on Thursday.

The man also collected benefits after falsely claiming his former wife had cancer, creating bills from fictional clinics, the newspaper said.

“We have reached the top of the pyramid in the realm of fraud,” the judge in the case is quoted as saying on Wednesday.

The defendant acknowledged starting to inflate real documents for medical prescriptions around nine years ago.

The false bills that he created were accompanied by documents necessary for the reimbursement of treatment supposedly received in Switzerland and Uruguay, 20 Minutes said.

The accused, who has been in detention for a year, testified that he sent a million francs to his home country, where his ex-wife and mother live, and he was now “ruined”.

He claimed that he suffered from depression that led him to shrug off the impact of his actions, according to the newspaper report.

His lawyer also pointed to negligence on the part of the insurance company, 20 Minutes said.

“An insurer that pays back 154 radiotherapy appointments, that’s shocking.”

An executive from the insurance company, however, said all the documents were “perfectly falsified”.

It was only in the autumn of 2012 when the insurer asked for a detailed medical report, which the accused refused to provide, that the company contacted the doctor mentioned in the false bills.

The doctor informed the insurer that the man was not her patient, leading to the accused’s arrest in March 2013, 20 Minutes said.

The prosecution is seeking a prison sentence of four years for the alleged fraudster.

Sentencing in the case is expected in the next few days. 

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LIVING IN SWITZERLAND

Taxes to work permits: Who deals with what in Switzerland?

Like other countries, Switzerland too is a bureaucracy, where various government agencies oversee different functions of public and private life.

Taxes to work permits: Who deals with what in Switzerland?

Unless you are a hermit and live off the grid, you will, sooner or later (probably sooner), have to deal with administrative processes of one kind or another.

In this respect, Switzerland is no different from any other nation, with the only difference being that because it is small and well-organised, the bureaucratic machine is running smoother here than elsewhere.

On the plus side, because it is fairly efficient, dealing with various public entities is probably less of a hassle in Switzerland than in less tidy administrations.

If you are a foreigner, especially a newly arrived one, you may not yet be familiar with the workings of various government agencies — in other words, who does what.

The first thing to know is that very few tasks that are likely to affect you personally are done at the federal level; most administrative processes are handled by cantons and municipalities.

These are some of the most important services, and who is responsible for providing them:

Pensions: federal and cantonal

The Federal Department of the Interior regulates and supervises obligatory pension plans, while the Federal Social Insurance Office implements the scheme.

Your pension, however, will be paid by your canton’s social insurance office

Work / residence permits: cantons

Permits are delivered by your canton, though the application procedure is different depending on whether you are an EU / EFTA national or a citizen of a third country.

Cantonal authorities are also responsible for renewing / extending expiring permits.

Taxes: cantons

As the cantonal tax office calculates how much taxes you owe in any given year, your declaration must be sent to cantonal authority

They will collect the cantonal, federal, and municipal taxes, distributing the money proportionally among them.

Driver’s license / car registration: canton

Anything related to driving — tests, licenses, vehicle registrations, and inspections — is the responsibility of cantonal automobile services

Health insurance subsidies:canton

If the monthly premiums of your obligatory health insurance (KVG / LaMal) exceed 8 percent of your income, then you may qualify for subsidies (premium reductions) from your  canton of residence.

You can apply for them here

READ ALSO: How do I apply for healthcare benefits in Switzerland?

Social aid: canton and municipality

Welfare assistance comes under the responsibility of your canton, which will consider your application and determine if you are eligible for financial help.

However, you should submit your application for assistance to your municipality, which will then transfer it to the cantonal welfare office.

As you can see, most public services are managed by cantons, so you may be wondering what is the role of your local municipality / commune?

They do their share as well.

For instance, they manage a register of residents, organise and maintain their own fire brigades, civil defence units and police forces (the latter two mostly in bigger communes).

They are also responsible for schools on their territories, as well as local energy supplies, municipal roads and parking, waste management, and infrastructure planning and upkeep, among other tasks.

READ ALSO: What exactly does your Swiss commune do?

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