– Unlawful denial of benefits based on lack of medical necessity – Some employees of benefits departments in private health insurance are engaged in strategic claims settlement for potentially up to more than nine million private health insurance policyholders. This means that one ignores if necessary also the supreme court iurisdiction and by own […]
Artikel zum Thema: Leistungsverweigerung
When are insurers no longer obliged to pay benefits or can reduce benefits?
– Liability traps and gaps in coverage in the daily sickness benefit insurance – In its ruling of July 6, 2016 (Case No. IV ZR 44/15), the Federal Court of Justice decided that regulations in the model terms and conditions (Section 4 IV MB/KT 2009) which regulated a compulsory reduction of the insured daily sickness […]
Risks of vandalism: No insurance cover in the event of refusal to pay protection money
– Why do you lose your insurance cover without paying protection money? – The Federal Court of Justice (BGH, ruling of 16.06.2010, file no. IV ZR 229/09) decided on the case of a restaurant owner who was threatened with damage or destruction of his premises that burglary and/or vandalism risks are to be reported […]
Invalid transactions with insurance buyers
– How the Federal Court of Justice legally and legitimately saves the insurers the additional payment(s) – Financial service providers, consultants and intermediaries, are looking for customers so that they receive more money from their contractual partner – a life insurance company (VR). However, these insurance buyers have great difficulties in developing legally secure business […]
Sale and assignment of pension insurance policies before own insolvency
“Live today – save later” – this is often the motto when an annuity insurance policy is to be sold for a one-off payment. Some insurers offer this to their customers due to an emergency situation even if there is no longer a contractual legal claim to it after the start of the pension. On […]
Live better today – and rely on a snowball system in the future?
The subject of pensions is not easy, but it is enormously important for the future, no matter what stage of life you are currently in. Network-Karriere has asked the Munich lawyer Dr. Johannes Fiala and the pension specialist Dipl.-Math. Peter A. Schramm to prepare the most important facts: “Live today, save later” is often the […]
Claims to daily sickness benefits despite partial retirement and also without loss of income
– Judgment of the Regional Court (LG) Nuremberg-Fürth confirms claims even without monetary need – Also with the conclusion of a sickness daily benefit (KT) insurance as so-called sum insurance, insurers try in many concrete cases to refer to the fact that the insurance customer had no damage by the inability to work, and […]
The pecuniary loss liability of the insurance broker and other financial service providers
What benefits the policyholder can expect from the insurer Passive insurance The aim of the insurance cover is to keep the policyholder free from liability obligations (BGH NJW 1967, 2203). This will also include claims for injunctive relief and removal pursuant to Section 1004 of the German Civil Code, for example in the case of […]