By signing this power of attorney, you authorize the employee benefit institution to transmit your personal data, including your sensitive personal data, to Helvetia. You also authorize Helvetia to process the data required for the clarification of your entitlement to benefits and settlement of the claim filed.

Furthermore, you authorise Helvetia to assess any entitlements to benefits you may have from Helvetia with regard to the Federal Insurance Contract Act on the basis of data obtained and, if necessary, to coordinate claims on the employee benefit institution and Helvetia.

Through this power of attorney, Helvetia is also expressly authorised to obtain relevant information and data as well as to inspect and be provided with relevant records (of a medical, professional, financial and legal nature, such as medical reports and reports of vocational guidance) from all public and private-sector insurance institutions (insurance companies and insurance institutions such as Swiss Federal Disability Insurance, Swiss Federal Accident Insurance, Swiss Federal Military Insurance, accident and health insurance companies, daily allowance insurers, co-insurers or reinsurers, employee benefit institutions, etc.) involved in these claims, as well as from the treating physicians, other healthcare providers, hospitals, medical institutions, employers, government agencies and authorities, such as residents' registration offices and investigative authorities, debt enforcement offices, tax authorities, etc. (hereinafter “third parties”).

You hereby authorise these third parties to give Helvetia or its medical service, upon request, the data required to clarify and process the claim and to transmit all relevant records and expressly release these third parties from their legal and contractual duty of confidentiality andsecrecy.

The third parties authorised to disclose information may transmit all data and records relevant to the settlement of the claim filed to Helvetia, even without the submission of a new request.

Finally, you authorize Helvetia to transmit all data relevant to settling the notified benefit case, including sensitive personal data, to the involved third parties in Switzerland and abroad, and to forward this data to the occupational benefits expert or the auditors on the basis of legal requirements.

In the event of failure to provide the present power of attorney, Helvetia will not be able to make the necessary inquiries, which may result in insufficient clarification of the scope of the incapacity for work or to earn and therefore lead to rejection of the claim for insurance benefits. Your authorisation is independent of any obligation to pay benefits on the part of your employee benefit institution.