Hartz IV judgment entitled to full costs of PKV

Hartz IV beneficiaries are entitled to take over the full costs of a private health insurance (PKV). This was decided today by the Federal Social Court in Kassel.

18/01/2011

The Federal Social Court in Kassel condemned a job center for the reimbursement of the full PKV health insurance contributions. Hartz IV recipients, who are insured in private health insurance, receive so far only from the service providers minimum contribution rate of the statutory health insurance. The difference contribution must be paid by those affected by the unemployment benefit II rate.

The 4th Senate of the Federal Social Court decided today in the hearing AZ: B 4 AS 108/10 R that the plaintiff has a right to the costs of private health insurance in full. The period of 2009 was negotiated. The lawyer practicing today had received Hartz IV benefits at the time. The responsible job center paid only the contribution, which also requires the statutory health insurance. The missing amount had to be paid by the person concerned. A change in the statutory health insurance was the plaintiff according to the current legal situation not possible, so that he had to remain in the private health insurance. The plaintiff therefore had to maintain the private health insurance with a contribution charge of 207.39 euros. Who pays the remaining balance, so far in the Social Code 2 (SGB II) is not clear and sufficiently clarified.

The federal social judges saw as proven that there is a legislative gap. So it says in the judgment: „The legislative material on the GKV-Competition-Strengthening Act can not be derived from sufficient evidence that the legislature wanted the privately insured relatives of benefits to secure livelihoods under the SGB II deliberately and intentionally wanted to leave them financially unsustainable contribution share“.

The existence guaranteed PKV insured person guaranteed by the constitution would be endangered, if the full contributions for the health insurance by the achievement carrier were not taken over. After all, the costs have to be borne by the job center, similar to the regulations for voluntary health insurance. Aufstlich also in the opinion. (Gr)

Picture: HHS