Changing tariffs in the PKV is worthwhile

Changing tariffs in private health insurance often makes sense even for those who have been insured for many years. It is not just a matter of saving on premiums, but of improving benefits.


Private health insurance (PKV) is cheap when you are young – because with statutory health insurance (GKV), contributions are based on income. Private health insurance, on the other hand, does not calculate quasi-socially, but proves to be predictably expensive from the outset in old age, when costly illnesses occur more frequently. This is because with each premium adjustment the additionally increased benefits are calculated according to the increasing age reached, in line with the statutory calculation guidelines. This is in line with the model of private health insurers, whose premiums at an advanced age can already amount to more than EUR 1,000 per month.

Tariff change: customers only pay if successful

Some insurance brokers who advise on tariff changes have revealed that their agents or employees successfully advise an average of four tariff changeovers per month, based on all employees, including advertising, accounting and management. Permanently employed agents who have fixed customer appointments and allegedly do not acquire customers receive a fixed salary and a performance-related commission. It is not said how many unsuccessful consultations fall on a successful one – but apparently the consulting employee has to sell his performance first.


Tariff change brokers often earn better than others

If you calculate 250 EURO contribution savings on average, and then 12 monthly contributions (MB) as a success commission as savings and remuneration payment, you would have 4 cases * 12 MB * 250 EUR = 12,000 EUR per month. Income, of which minus profit, room costs, advertising, one can certainly pay 3,000 to 4,000 EURO gross monthly to the employees, including success commission, and still achieve about 2,000 EURO net profit per employee. For example, with 70 employees currently working for the aggressively advertising tariff change broker, he would then make a monthly profit of 140,000 EUR. After this example, the following applies: It still pays off.


High failure rate – demanding customers

However, the consultant only gets an appointment with a “demanding” customer. The failure rate is likely to be relatively high, because the customer cannot see from the advertising that and how much he has to pay. There is an increasing number of such providers who advertise aggressively, so that customers have the choice before they place an order.

Ultimately, the consultant will have to make an acquisition in the appointment and will often fail because the customer will then be looking for an alternative – for example, advertising just as aggressively with the others – the optimizers -, will himself request an offer from the insurer, will contact an insurance consultant or expert, especially if he perhaps only has a remaining question or would like to have the offer from the insurer checked again.


More favourable through success-independent fee consulting?

Not only then, however, the customer is saved e.g. 250 Euro * 12 premium saving months * 1.19 for VAT. = 3,570 EUR too expensive. In the case of an expert or insurance consultant, for example, he pays only 450 – 850 EUR on an hourly basis, depending on the work involved. Experience shows that tariff change optimizers have often already done the work and in the end earn nothing, because the customer rejects the tariff change – at first – only to implement it much more cheaply perhaps a year later with the help of a consultant or expert working on an hourly basis.

Neither can collective bargaining brokers advise on the reorganisation of company relationships, partnership and employment contracts, or any conceivable anticipated succession. “If you can see any problem as a nail, the hammer alone is enough as a tool.” In this context, it is also possible to achieve the statutory insurance obligation and to switch to statutory health insurance at an advantageous price at an older age by retaining the private health insurance in individual modules or supplementary insurance. However, this does not work without knowledge of tax, inheritance and company law. Whether one is really better off there, however, can be questionable. Some solutions of the tariff change optimizer later turn out to be deficient, also due to a lack of comprehensive knowledge of the circumstances, or at best the first partial step on the way to comprehensive knowledge of possible solutions, which could then last for more than a few years.


Tariff change should become less attractive

Meanwhile the German Association of Actuaries has proposed to politicians that the savings made when changing tariffs should be more strongly limited by retaining a larger part of the ageing reserve, which would then be used instead to absorb subsequent premium adjustments. This will probably halve the source of income of the tariff change optimizers, which is measured by savings.

Example: Customer pays 750 EURO, the tariff now costs 1200 EURO, discount from aging reserves then 450 EURO, bill of exchange tariff now costs 850 EURO, minus the discount of 450 EURO the customer pays 400 EURO after the bill of exchange, which results in a saving of 350 EURO per month. means. With the new procedure he pays about 540 EURO after the change, which means a saving of only 210 EURO.

In addition, not only the income per success decreases, but also the success rate, because the change becomes less interesting. This requires the legislator, to whom it is sold as a measure to stabilise premiums and prevent high premium adjustments, which is quite understandable.

PKV announces a transparency offensive – with this some tariff change brokers die out. In addition, there is the advertised transparency offensive of the private health insurance companies as a voluntary commitment when changing tariffs, with which from 2016 at the latest the tariff change optimizers are to be expressly curbed, of which the press also warns somewhat cautiously in some cases, despite the advertising revenue.

At the same time, private health insurance customers already have the option of asking for good advice from the private health insurance company, completely free of charge and possibly also in terms of content.

Because if the private health insurance is addressed to concrete problems in an appropriate way, there is a duty to advise – as in any other insurance branch since 01.01.2008, § 6 of the German Insurance Contract Act (VVG). It makes sense not only to request information from the insurer, but also to expressly request advice in accordance with § 6 VVG on possible tariff changes. On the other hand, the insurer is not obliged to offer favourable tariffs for a tariff change on its own initiative without being requested to do so and without any recognised need for advice.



by Dr. Johannes Fiala, RA and Dipl.-Math. Peter A. Schramm

published on (08.06.2015


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About the author

Dr. Johannes Fiala Dr. Johannes Fiala

Dr. Johannes Fiala has been working for more than 25 years as a lawyer and attorney with his own law firm in Munich. He is intensively involved in real estate, financial law, tax and insurance law. The numerous stages of his professional career enable him to provide his clients with comprehensive advice and to act as a lawyer in the event of disputes.
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