Suffering a loss is stressful enough. It becomes even more frustrating when the insurance company delays payment, reduces benefits, or rejects the claim entirely. In Switzerland — where insurance contracts are often complex and vary significantly — a structured and strategic approach is crucial.
This guide explains the steps you should take after a loss, when legal support becomes necessary, and how Legal XII Tables Avocats can assist you.
1. Immediate Measures After the Loss
Right after the incident, you should:
- document the damage (photos, videos, invoices, reports),
- identify and secure witnesses, if available,
- notify the police or emergency services when required,
- report the claim to your insurer without delay,
- check applicable deadlines (particularly in liability, accident, or disability cases).
A complete and consistent documentation record is often decisive in avoiding disputes later about the scope or extent of the damage.
2. Filing the Claim Correctly and Completely
Insurers may deny benefits if:
- information is incomplete,
- the claim is submitted late,
- inconsistencies appear in the statements,
- contractual duties are breached (e.g., duty to mitigate damage).
Ensure that you report only verifiable facts — not assumptions.
Misunderstandings tend to escalate quickly in insurance law.
3. Reviewing the Insurance Conditions (GTC/AVB) and the Policy
Whether an insurer must provide benefits depends on:
- the individual insurance contract,
- the General Terms and Conditions (AVB),
- special statutory provisions, particularly the Swiss Insurance Contract Act (VVG).
Older or customised contracts often contain specific clauses that are difficult for non-experts to interpret.
A lawyer can assess:
- Is the damage covered at all?
- Are there any exclusions the insurer may legitimately rely on?
- Are there interpretive arguments in favour of the insured?
- Did the insured breach any obligations — and are the consequences proportionate?
4. When the Insurer Reduces or Rejects Benefits
In practice, we frequently see:
- delayed claims handling,
- systematic reductions of benefits,
- rejections with standardised reasoning,
- restrictive interpretations of exclusion clauses,
- unjustified blame placed on policyholders.
At this stage, professional legal support becomes essential.
A lawyer specialising in insurance law can:
- review the insurer’s decision,
- draft a legal response or position statement,
- file an objection or appeal,
- obtain medical or technical expert reports,
- conduct settlement negotiations,
- enforce claims in court.
Legal XII Tables Avocats regularly represents clients in such situations — efficiently, strategically, and with a high success rate.
5. Particular Challenges in Liability and Personal Insurance
Insurance law is not uniform. Particular complexity arises in:
- Private liability: disputes on intent, gross negligence, or coverage gaps,
- Motor liability: interaction with traffic law regulations,
- Household and property insurance: valuation, depreciation, underinsurance,
- Accident insurance (UVG/UVV): causality, incapacity for work, daily allowances,
- Health and supplementary insurance: benefit reductions, rehabilitation issues,
- Disability insurance: medical assessments, burden of proof, long-term implications.
In these areas, early legal assessment is especially recommended.
6. When Should You Involve a Lawyer?
Engaging a lawyer is necessary when:
- benefits have been reduced or denied,
- contractual clauses are unclear,
- claim processing is delayed,
- the amounts at stake are significant,
- medical or technical expert reports are involved,
- you feel treated unfairly,
- a company is the policyholder.
The earlier legal advice is sought, the greater the likelihood of resolving the matter out of court.
Conclusion: Professional Support Saves Time, Stress, and Costs
Insurance companies operate professionally, systematically, and with legally trained departments. Policyholders should therefore not hesitate to secure comparable legal expertise.
Legal XII Tables Avocats — led by attorney Lionel Patrick Serex — provides discreet, efficient, and strategic support in all areas of insurance and liability law, with a clear focus on enforcing your rights.
➡️ Book an online consultation:
https://legal12tablesavocats.ch/en/e-service/
