Dental damage report

Make things easy for your patients and our insured persons. By filling out the dental damage form, you help speed up our handling of their claim for accidental dental injury.

Claim reporting by dentists

Please make sure to fill out the form specifically designed for this purpose and send it to us along with your patient’s relevant documents. Submitting this form means the dental damage has been reported to us and we can then assess any consequential damage.

Cost estimate with SSO tariff / tariff 96

Please send us your cost estimate using the tariff applicable to general health insurance (tariff point value CHF 3.10, SSO dental tariff 96). The Dentotar tariff is not valid for general health insurance.

Submit dental damage report and cost estimate

The easiest way to submit the completed dental damage report, together with any cost estimate, is online.

Submit report

Enter the patient’s client number & date of birth, upload the completed dental damage report, done! Alternatively, send it by post to: CSS, Postfach 2550, 6002 Luzern.

Additional notification of how the accident happened

Your patients must additionally notify us of the circumstances leading to the accident. They can do this by using the form to be found on the report an accident page.

Legal requirements

The obligation to pay benefits for dental treatment is governed by Article 31 of the Federal Health Insurance Act (KVG) in conjunction with Articles 17 to 19 b) of the Health Insurance Benefits Ordinance (KLV). The KLV sets out in full which services are to be covered by basic insurance. As a rule, general health insurers are not required to provide benefits for dental treatment unless that treatment is related to one of the underlying diseases set out in the Ordinance.

This article defines the scope of benefits. It states that insurers may not cover any costs under basic insurance other than those set out in Articles 25 to 33. Under prevailing case law, treatment of the jaw is to be classed as dental treatment. In other words, all diseases of the masticatory system, the teeth, the periodontium and the jaw are to be considered dental treatment.