What the tariff change broker never reveals and rarely knows

The Ministry of Economic Affairs has submitted a draft bill to transpose the EU Insurance Distribution Directive IDD into German law. Accordingly, the ban on commissions remains in force and in future there will be “fee-based insurance consultants

The SHI system should become more attractive for the self-employed. In the guest article, attorney Dr. Fiala is surprised about this demand. And he explains how quickly insurance brokers give false advice if they do not fully point out the possibilities of SHI membership for the self-employed.

A recent study by a lobby organisation proposes to make statutory health insurance (GKV) more attractive for lower earning self-employed persons, as reported by a newspaper from Southern Germany. For self-employed persons there would be a minimum contribution of 342 euros per month. It is astonishing what journalists take over unchecked, for example when the deception is taken to extremes by the journalist joining the demand for a change in the law according to which self-employed persons are paid according to income. This leads to the question of how this happens. Just pure lobbying of the SHI, ignorance or intention?


SHI-insured persons can also pay less than the minimum contribution – on request

No SHI system voluntarily points out that self-employed persons can also apply to pay a lower contribution than the so-called minimum contribution to SHI if they have a lower income. You have to figure it out for yourself. Or, for example, seek advice from the SHI system and, if the advice is incomplete, later bring an official liability action for damages against the SHI system.

The legal “trick” is to contradict the contribution classification with the minimum contribution – and to keep the justification open by means of proof of income to be submitted later, such as the tax assessment notice. Some unfriendly clerks at the SHI do not express “reservations”, thus unnecessarily provoking an objection procedure, and accept that naive self-employed persons with a monthly profit of about 342 Euros may pass this money one to one to the SHI. Otto, the average consumer, does not learn such vulgarities at school.

However, the term “minimum contribution” does not mean that this is the minimum contribution that the self-employed person must actually pay. Just as the minimum penalty according to the StGB can be lower again because of § 49 StGB, apart from the fact that early release is possible afterwards, or a pardon by the Federal President e.g. in view of winning the European Football Championship.

The reverse occurred earlier, the conversion of a dungeon penalty into a death penalty (wheels, quartering and hanging between the goalposts) to make room in the dungeon for the losing team, except for the goalkeeper who was shot from the penalty spot.


Ongoing false advice from insurance brokers

Of the approximately 9 million persons fully insured in private health insurance (PKV) only about 1.4 million are self-employed plus about 400,000 family members. The lobby organisation, a proper foundation, also promotes the unnecessary departure from the statutory health insurance system by disseminating half-knowledge, and later poverty in old age of the self-employed through high private health insurance contributions.

However, it is not uncommon for it to be more advantageous to remain in the private health insurance system – an examination in individual cases is therefore always advisable.

If the possibility of lower contributions for the self-employed on application is hardly known to insurance brokers, and the self-employed are therefore transferred to private health insurance for the (apparent) contribution savings, this is false advice and the self-employed can demand compensation in the amount of the premium to be paid in private health insurance minus the contributions to be paid in statutory health insurance on application according to income: In addition, the cost of benefits which the private health insurance does not pay but which the statutory health insurance would have covered. In court, this will be enforced first as an action for a declaratory judgment and then as an action for payment – an actuarial expert opinion will be able to present and quantify the amount of the loss.


More favourable SHI contribution by founding a small GmbH

In fact, the minimum contribution for self-employed persons in 2016 is 137.57 euros plus an additional contribution from the individual insurance company plus nursing care insurance. And if this is still too expensive for you, you can also sell, lease, rent out, or leave your business to the next generation through an anticipated succession – or to a good friend. If you are a former self-employed person and only an employee there, you may pay even less – and this quite legally, if everything is organised correctly and actually carried out in the same way, i.e. not just for appearances.

Switching to statutory health insurance is also possible and attractive at age 55 and over

Those who have not returned to the SHI system until shortly after the middle of their working life are not compulsorily insured in the health insurance scheme for pensioners (KVdR), with about half the usual contribution. The disadvantage of this is that you become a voluntarily insured person and thus do not escape the contribution of capital and rental income. It can be different if well designed compulsory insurance exists for other reasons – even as a pensioner. The optimised design can save a six-figure sum, even if you have already reached the age of 55 and can no longer easily switch to statutory health insurance. Regularly, one can hardly expect help and advice from the SHI on how the changeover works. The own PKV insurance broker has no increased interest in this either.

The privilege of the KVdR, i.e. the reduction of contributions at retirement age, refers to the time of the start of retirement with the Deutsche Rentenversicherung Bund (DRV), regardless of whether full or partial pension is paid. If necessary, you have to postpone the start of your pension there – and in return you get a bonus in the pension amount. Moreover, one must not have been admitted to the SHI system only after the age of 55.


One day in the statutory health insurance system is enough – the practice can be different

One day in the statutory health insurance – no matter how you got in – is enough to have to stay in it, if you do not prove that you are covered otherwise. Another question is how income and assets are then subsequently structured so that a suitable classification of contributions can be made. Both are first of all different questions, with possibly different criteria.


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


by courtesy of

http://www.procontra-online.de/ (published on 01.12.2016)






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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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