Changing tariff in PKV: options within an existing contract

What the law provides

Under § 204 para. 1 VVG, you can require the insurer to accept applications to switch to other tariffs with similar insurance cover. The rights acquired under the contract and the ageing reserves must be credited. A switch can make sense if you want to lower the contribution or obtain better cover.

Switching with additional benefits

If the benefits in the new tariff are higher or more comprehensive, the insurer may require a benefit exclusion, an appropriate risk surcharge or a waiting period (Wartezeit) for the additional benefit. BaFin points out that a health assessment (Gesundheitsprüfung) is also possible for this. You can avoid this by waiving the additional benefit.

Advice and information from the insurer

According to BaFin's guidance, the insurer must take the rights acquired so far into account and advise on a tariff change. In the case of contribution adjustments, it must also point out the right to switch. It is best to request target tariffs and their terms in writing before you decide.

Switching to another insurer

Switching to another insurer is something different from a tariff change within the existing contract. According to BaFin, for contracts concluded after 2009 part of the ageing reserves can be transferred, but not for older contracts. In addition, the new insurer asks health questions and, except in the basic tariff, is not obliged to accept you.

Basic tariff

Switching to the basic tariff (Basistarif) is only possible under § 204 VVG under certain conditions, including a contract concluded after 2009 and an age over 55 years, or receipt of a pension or need for assistance (Hilfebedürftigkeit). In the basic tariff, risk surcharges and benefit exclusions are not permitted. It is to be understood as an option, not as a standard solution.

Checklist before a switch

• Which benefits fall away or are added? Compare benefit descriptions, not just the contribution.
• How do deductible and contribution development affect you in the long term?
• Does the insurer require a surcharge, exclusion, waiting period or health assessment for additional benefits?
• Are the ageing reserves and acquired rights credited in a comprehensible way?
• Do you have all commitments and terms in writing?

Which options exist in your contract can only be judged on the basis of your terms and tariffs. This overview does not replace legal or professional advice.