Why do many Swedish citizens feel violated, lose confidence in the authorities or get confused and frustrated when disputing denials of sickness cash benefits? What exactly happens when their appeals to internal reconsideration units and tribunals fail? This thesis applies an anthropology of law approach to questions of culture and rule of law in Swedish sickness insurance. Similar to the United States during the 1980s and the United Kingdom in recent years, Sweden experienced controversy regarding sickness insurance in 2005–2008 and 2015–2018. This study asks to what extent the trajectory that such controversy has followed in Sweden can be explained by a more or less premodern administrative legal culture. As a rule-of-law ethnography, this study provides historical contextualisation, meta-analysis of previous research, detailed case studies, analysis of debate in the media, and in-depth interviews with legal professionals. Taken together, these ethnographic data suggest a social order based on state prerogatives, weak elite accountability and conflictful paternalism, rather than modern Western rule of law.