Benefit regulation of the private health insurance (PKV) after desired treatment success

– 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 […]

Risk surcharges in private health insurance lead to disproportionate premium increases

– Why tariff change optimizers contribute to old-age poverty –   Risk surcharges in private health insurance are intended to compensate for people with pre-existing conditions that the normal tariff premium is calculated only for people with normal risk. Since treatments for pre-existing conditions and their consequences also become more expensive over the years already […]

Training liability in insurance, capital investment and bank sales

Why training and sales managers are personally liable in private health insurance sales. An analysis by attorney Dr. Johannes Fiala and mathematician Peter A. Schramm.   Landauf Landab insurance brokers, independent financial service providers and bank advisors complain that at sales events held by trainers, they actually only experience positive product features through colourful pictures, […]

Federal Supreme Court prohibits insurance consultants from charging contingency fees for changing tariffs in private health insurance

– How the insurance consultant with a second job may do exactly this and more nevertheless –   Insurance brokers as well as insurance consultants are allowed to offer policyholders (VN) in private health insurance (PKV) at the change of tariff according to the new tariff. § Section 204 of the German Insurance Contract Act […]

Pension funds are not allowed to withhold health insurance contributions on private pension part

– This leads to further legal disputes about the “correct” determination of contributions –   The Federal Constitutional Court (BVerfG, decisions of 27.06.2018, ref. 1 BvR 100/15, 1 BvR 249/15) decided that benefits from a pension fund (PK) – which are based on contributions made privately by the employee – are not subject to any […]