Special right of termination at PKV tariff increase

Special right of termination at PKV tariff increase

An increase in private health insurance tariffs does not have to be tolerated: Affected persons can make use of their special right of termination or complain if the private health insurance undertakes pay increases.

30.11.2010

As already reported, numerous private health insurance companies (PKV) will increase their contributions in the coming year. Since on the one hand it can be assumed that many insured persons will not accept the premium increases and instead will make use of their extraordinary right of termination and the experts expect that the health care reform will increase the number of privately insured persons, the industry expects substantial amounts for 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 adopted to provide more support to private health insurance companies in the future. Thus, the change between the statutory health insurance (GKV) and the PKV is facilitated, the previously limited to GKV drug discounts are extended to the private health insurance and the private insurers particularly lucrative business of supplementary insurance is the statutory health insurance in the future prohibited. However, although private health insurers can look forward to substantial additional revenue, cost reductions and new customers in the course of the concessions made by the black and yellow government, numerous private insurers have informed their customers about upcoming increases in contributions at the end of the year. Up to ten percent want among other things the private health insurance Central and the old Oldenburger increase their contributions in certain tariffs.

Complaint to the ombudsman about the increase of the contribution possible
Customers who disagree with the appropriate premium adjustments may complain to their insurance company or the relevant ombudsman about the increase in premium. 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 glance at the tariffs of the market leader DKV illustrates. However, termination must reach the respective insurance company by the end of 2010 at the latest (one day before the entry fee enters into force). Of the 3.1 million DKV members, insured persons will have to make higher contributions in the future in just under a quarter of the more than 90 tariff variants offered. Not only various full insurance policies, but also the subsidy insurance, sickness allowance insurance, supplementary long-term care insurance and supplementary insurance for statutory health insurance protection are affected by the premium adjustments. According to the DKV, the premium adjustment was necessary to offset the rising costs of medical treatment.

In this case, insured persons of the DKV can offer a change of insurance for those affected, because not all private insurance companies have increased their contributions equally. Also, the increased competitive pressure associated with the increased insurance changes would, according to the experts, lead to the fact that the private health insurance may be more restrained in the future with their contribution increases. Because the competition is so far the only price brake, which keeps the private insurance companies from expanding their contributions as desired - unlike in the GKV legislature here is no upper limit. For example, there is a risk that private health insurers will increase their contributions for the sole benefit of profit if the price pressure in the industry is not great enough.

Statutory health insurance is weaker
The statutory health insurance companies see their position against the PKV considerably weakened by the health care reform. In particular, the contribution increase and the additional contributions provided by the legislature, in connection with the simplified change possibilities, could lead to a considerable loss of members of the statutory insurance, according to the fear of the GKV-Spitzenverband. Also, the increase of the contribution rate by 0.6 percent would not have been necessary, „if there had been a real, more dedicated austerity package“, states in a statement of the Association for health reform.

However, the federal government with the GKV financing law „ensured that the finances of the statutory health insurance in the coming year on a solid foundation“ stressed Doris Pfeiffer, CEO of the GKV-Spitzenverbandes and added that despite the increased competitive pressure from the direction of private health insurance „Closure or insolvency of health insurance funds (...) by the GKV financing law (...) largely excluded“ become. In recent years, the SHI had mostly recorded high losses, as the revenue was not sufficient to cover the necessary expenditure. However, with the health reform decided in November 2010, or in particular with the increase in the contribution rate, these deficits have been eliminated for the time being. Possible future deficits are to be absorbed by statutory insurances according to the will of the legislator, primarily through the levying of additional contributions. The fear of the social organizations and opposition parties, however, is that the GKV due to the contribution increases, the additional contributions and the simplified change options in the coming years, the members run away and predominantly the problem cases (for example, chronically ill, people in need of care), which in the PKV due to the Pending costs are not accepted as customers, collect in the statutory insurance. This would not only significantly increase the deficit in the statutory health insurance, but the entire solidarity principle in the health system would be nullified. (Fp)

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