– 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: PKV
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 […]
Cologne Higher Regional Court: Premium adjustments in private health insurance often ineffective!
– OLG Cologne judges generally usual procedure of the PKV as inadmissible – In its judgment of 20 July 2012 (Case No.: 20 U 149/11), the Cologne Higher Regional Court ruled that a procedure used for decades by private health insurers for premium adjustments was incorrect. As a result, many premium adjustments since 1995 […]
Private health insurers (PKV) cannot reduce the daily sickness allowance
– How the Federal Court of Justice (BGH) has put an end to mass litigation – The Federal Court of Justice (BGH) ruled (judgment of 06.07.2016, Case No. IV ZR 44/15) that a reduction of the daily sickness allowance as well as of the insurance premium pursuant to Section 4 IV of the Model […]
Private health insurance (PKV) at an economy price – for up to less than 100 euros per month
– How to save thousands of dollars every year with good nerves and advice? – The “last chance for privately insured people” is advertised en masse on the Internet, through ads that lead to the tariff change broker. For a few thousand euros the premium is lowered, by a tariff change. Two horse feet […]
Insurance benefits and insurance premiums in the event of insolvency of the insurance customer
Insolvency creditors normally have to register their claims in the table and can immediately write off up to more than 90%. The rate is often just above zero. Nevertheless, there are numerous exceptions to the rule of how to get your money despite the insolvency of the debtor. Maintenance obligations and intentional tort […]
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 […]
Why do insurance brokers have only limited duties of advice and documentation?
The Higher Regional Court (OLG Hamm, decision of 5 December 2018, file no. 20 U 146/18) confirmed the dismissal of the complaint regarding the (alleged) miscounseling by an insurance broker when changing the cover of a private health insurance. The new private health insurer had later challenged the contract because of incorrect answers to the […]
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 […]