– Why optional tariffs and more are nevertheless being extended by health insurance companies – The BSG judgement of 30 July 2019 (file number B 1 KR 34/18 R) has shown that the problem of the optional tariffs offered by the health insurance funds, for example for abroad, optional services in hospitals or supplementary dental […]
Artikel zum Thema: PKV
Federal Court of Justice: Insurance brokers do not have to look after customers on a permanent basis
– Why a broker is allowed to give advice on changing tariffs for a contingency fee – The Federal Court of Justice decided (BGH, ruling of 28.06.2018, file no. I ZR 77/17) that an insurance brokerage contract does not require that the client is to be looked after on a permanent basis according to […]
When insurers are obliged under the DSGVO
On 25.05.2018 the basic data protection regulation of the European Union (EU-DSGVO) came into force. Regulations apply directly and immediately – implementation by national legislators is not required. Meanwhile, further regulations and directives are in preparation, which are potentially intended to restrict freedom of expression – for example to counter fake news. No information […]
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 […]
Voluntarily insured pensioners pay too high health insurance contributions
– How self-employed persons and pensioners are also transferred from pension schemes to compulsory insurance – Typically, (compulsory) members of the 89 professional pension schemes are either privately insured in old age (PKV) or voluntarily insured by the statutory health insurance system (GKV) at too high a price. However, this also frequently affects former self-employed […]
Compensation from the (professional) guardian after termination of insurance
The OLG Koblenz (judgement of 28.02.2018, file no. 4 W 79/18) decided on the liability for damages of a professional caregiver after he or she had terminated a private health insurance (PKV) together with a supplementary nursing care insurance (PV) and a short time later the benefit claim occurred. Liability in the event of […]
How trust in the occupational pension scheme can be destroyed
Falsification and concealment of balance sheets are punishable under § 331 No. of the German Commercial Code (HGB). Famous examples of such manipulations would be the Olympus and Enron companies, or more recently P&R. The “Heubeck mortality tables RT 2018 G” (dated 20.07.2018) were allegedly erroneously prepared and later withdrawn – this was the responsibility […]
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 […]
IDD implementation: New business models for Insurtec’s and insurance consultants
The implementation of the Directive EU 2016/97 of the European Parliament and of the Council of 20 January 2016 on insurance distribution, i.e. the Insurance Distribution Directive (IDD) by Section 43c of the German Insurance Supervision Act (VAG), leads to financial risks for insurers (VR) and insurance brokers (VM). The insurer may be allowed to […]
Civil servants are not compulsorily insured either in the private or the statutory health insurance
The Regional Social Court of Berlin-Brandenburg (ruling of 30 November 2017, file no. L 1 KR 446/15) ruled that civil servants “are to be regarded as entitled to state aid without restriction and thus otherwise secured”. Since 01.01.2009, it has been up to each civil servant to decide whether to take out a private […]