Kernrechtsfrage
Whether the insured could rely on good faith to obtain full reimbursement of the eye prosthesis invoice.
Extrahierter Entscheid
Yes. The authority's prior conduct and sparse communications created protected reliance, so limiting reimbursement without prior warning violated good faith.
Extrahierte Begründung
The office repeatedly accepted earlier prostheses and paid the first two invoices in full, had never clearly warned of a future cap, and the later tariff convention could not defeat justified reliance without prior information.