Complaint against SZV triggers systemic Ombudsman investigation

GREAT BAY--The Ombudsman has launched a systemic investigation into the administrative practices of Social and Health Insurance (SZV), following a complaint involving the suspension of medical treatment abroad, the forced repatriation of an insured person, and the imposition of financial consequences without a formal written administrative decision. The investigation has been launched at the level of the functionally responsible government body, namely the Minister of VSA. This escalation follows what the Ombudsman described as a lack of cooperation from SZV in response to queries concerning not only the case itself, but also the legal and policy basis for its actions.

The investigation stems from a complaint involving an insured person who had been referred abroad for medical treatment. According to the complaint, the treatment was suspended and the patient was repatriated before the completion of scheduled procedures. SZV reportedly stated that the measure was based on an alleged violation of its Regulation on the Duties, Rights, and Responsibilities of the Insured during Medical Referral Abroad (RDIRA). However, despite repeated requests, no formal written decision was issued setting out the factual basis, legal grounds, or available legal remedies.

Following the complaint lodged with the Bureau Ombudsman in December 2025, the Ombudsman formally requested information from SZV, including clarification of the legal basis for its actions and access to the alleged evidence said to justify the measures taken. Since then, the Ombudsman says SZV’s responses have been marked by significant inconsistencies and procedural barriers.

The Ombudsman notes that under Article 3 of the Landsverordening administratieve rechtspraak (LAR), measures such as suspending medical treatment, repatriating an insured person, or imposing financial obligations constitute administrative decisions and must therefore be issued in writing. The Ombudsman warns that allowing public bodies to impose measures with legal and financial consequences without formal written decisions undermines fundamental principles of good governance and the right of citizens to seek judicial review.

Although the matter originated from an individual complaint, the Ombudsman says the issues raised may point to broader structural concerns in the administrative practices applied in cases involving medical referrals abroad.

Persons who have experienced similar issues with SZV regarding medical treatment abroad, repatriation, or unresolved administrative decisions are encouraged to contact the Bureau Ombudsman at E.C. Richardson Street #13, by telephone at 542-1243, or by email at info@ombudsman.sx

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The Ombudsman listens, investigates, and recommends government to act on the concerns of the people. The Ombudsman is the Voice and Protector of the People.

Based on the Ombudsman’s published procedures and past systemic investigation reports, a systemic investigation is generally launched when the Ombudsman suspects that an administrative task is structurally not being performed properly, or when an individual complaint reveals a broader pattern affecting the public interest.

The Ombudsman then issues a formal Notification of Systemic Investigation, requests information and documents from the relevant ministry, agency, or entity, reviews the applicable procedures and legal framework, and may first issue a Preliminary Findings Report for comment before submitting a Final Report with findings and recommendations to the responsible authority. The Ombudsman’s reports also note that these investigations may be initiated on the Ombudsman’s own initiative and are aimed at assessing whether government action was fair, transparent, and in keeping with proper administrative conduct.

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