Health questions in BU: preparation and complete information

What the law requires

Before the contract is concluded, you must disclose to the insurer the circumstances known to you that are significant for its decision, insofar as it asks about them in text form (§ 19 para. 1 VVG). What counts are therefore the questions asked. Answer them exactly as they are worded, with the period and scope stated there.

What can happen if information is wrong

• In the case of intent or gross negligence, the insurer can withdraw from the contract.
• In the case of slight negligence, withdrawal is excluded; a right of termination comes into consideration.
• If the insurer would also have concluded the contract with correct information, only on different terms, it can demand these retroactively.
• Its rights presuppose that it informed you of the consequences by a separate notice in text form (§ 19 para. 5 VVG).

The insurer must exercise its rights in writing within one month after it learns of the breach. After five years from conclusion of the contract they expire, and in the case of intent or fraud after ten years (§ 21 VVG). Do not rely on these deadlines: in the event of a claim, insurers usually check the information closely.

How to prepare

• Establish exactly what is being asked and for what period, such as treatments, diagnoses or medication.
• Put together doctor visits, diagnoses and treatments from your memory and your documents. If necessary, ask your doctors and your health insurance fund for an overview.
• If in doubt, do not answer questions from memory alone, but on the basis of the documents.
• Ask if a question is unclear, and record the answer in writing.
• Keep a copy of the application with all the information.

Clarifying pre-existing conditions in advance

If you have pre-existing conditions, an anonymous preliminary risk assessment can help. It shows how insurers are likely to assess your information before an application is made. The Verbraucherzentrale recommends the support of an experienced intermediary or an independent insurance adviser (unabhängiger Versicherungsberater) for this.

This article does not replace legal advice. How your specific information has an effect depends on the individual case and the contract terms.