Special right of termination in the case of a PKV tariff increase

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Special right of termination in the case of a PKV tariff increase

There is no need to accept an increase in private health insurance tariffs: those affected can exercise their special right of termination or complain if the private health insurance provider increases the tariff.

As already reported, numerous private health insurance companies (PKV) will increase their contributions in the coming year. On the one hand, it can be assumed that many insured persons will not accept the increase in premiums and will instead make use of their extraordinary right of termination and, on the other hand, the experts expect that the number of privately insured persons will increase sharply due to the health care reform, the industry expects considerable increases in the coming year Upheavals.

Numerous measures in the sense of private health insurance
In the course of the health reform of the Christian-liberal federal government, numerous measures were decided to support private health insurance more in the future. This will make it easier to switch between statutory health insurance (GKV) and private health insurance, the pharmaceutical discounts previously reserved for statutory health insurance will be extended to private health insurance, and the future health insurance companies will no longer be able to do business that is particularly lucrative for private insurers. But although the private health insurance company can look forward to substantial additional income, cost reductions and new customers as part of the concessions made by the black and yellow federal government, numerous private insurers have informed their customers about upcoming premium increases at the end of the year. Central private health insurance and Alte Oldenburger, among others, want to increase their premiums in certain tariffs by up to ten percent.

Complaint to the ombudsman about the increase in contributions possible
Customers who do not agree to the relevant premium adjustments can complain to their insurance company or the responsible ombudsman about the premium increase. You can also exercise your special right of termination or the right to change tariffs within four weeks. A change of insurance can be worthwhile, as a look at the tariffs of the market leader DKV shows. However, the cancellation must reach the respective insurance company by the end of 2010 at the latest (one day before the new contribution rate comes into force). Of the 3.1 million members of the DKV, the insured will have to make higher contributions in the future for just under a quarter of the more than 90 tariff options offered. Not only various full insurances are affected by the premium adjustments, but also the subsidy insurance, the daily sickness benefit insurance, the supplementary nursing care insurance and the supplementary insurance for SHI protection. According to the DKV's own information, the premium adjustment was necessary to compensate for the rising costs of medical treatment.

For those affected, insured persons at DKV can offer a change of insurance, because not all private insurance companies have increased their premiums equally. In the opinion of the experts, the increased competitive pressure associated with the increased insurance changes would also mean that private health insurance providers may be somewhat more reluctant to increase their premiums in the future. So far, the competition has been the only price brake that prevents private insurance companies from expanding their premiums at will - unlike in the GKV, the law does not set a maximum limit here. There is a risk that private health insurers will increase their contributions out of pure profit if the price pressure in the industry is not great enough.

Statutory health insurance companies see themselves weakened
Statutory health insurers see their position vis-à-vis private health insurance considerably weakened by the health care reform. In particular, the increase in premiums stipulated by the legislature and the additional premiums in connection with the simplified exchange options could lead to a significant loss of members in the statutory insurance, so the GKV head association feared. Nor would it have been necessary to raise the contribution rate by 0.6 percent "if there had been a real, more committed austerity package," says the association's statement on health care reform.

However, with the GKV Financing Act, the Federal Government "ensured that the finances of statutory health insurance will be on a solid foundation in the coming year," emphasized Dr. Doris Pfeiffer, CEO of the GKV umbrella association, added that despite the increased competitive pressure from the private health insurance sector, "closures or insolvencies of health insurance companies (...) are largely excluded by the GKV financing law (...)". In recent years, the statutory health insurance has mostly suffered high losses because the income was insufficient to cover the necessary expenses. However, with the health care reform decided in November 2010 and in particular with the increase in the contribution rate, these deficits were initially eliminated. According to the will of the legislature, any future deficits should primarily compensate for statutory insurance by charging additional contributions. However, the fear of the social associations and opposition parties is that the SHI will run away more and more due to the increase in contributions, the additional contributions and the simplified exchange options in the coming years and mainly the problem cases (e.g. chronically ill, people in need of care), which the PKV due to the upcoming costs are not accepted as customers, collect in the statutory insurance. This would not only significantly increase the deficit in statutory health insurance, but would also undermine the complete principle of solidarity in the health system. (fp)

Also read:
Numerous private health insurance companies are planning to increase premiums in 2011
Private health insurance should take inflation into account when retiring a pension
PKV premium increases of up to eight percent?
PKV association sees no losses

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