PKV-Emergency plan: insurer the cost of treatment may set off with the old contribution debt

In the so-called emergency tariff of the private health insurance (PKV) the insurer’s current cost of treatment offset with old Arrears. The Federal court of justice (BGH) decided in Karlsruhe with a on Friday published judgment. After that, a man from lower Saxony hospital treatment must pay costs in the amount of 1900 euros, according to its contribution to reduce the debt. (Az: IV ZR 81/18)

The man is insured since 1983, in the case of a private company, could not be more last to pay the contributions. That’s why he came in 2016, the “emergency tariff”. This was introduced in 2013. The monthly contribution is currently only 79,14 Euro. For a treatment claim only in the case of chronic diseases, pregnancy and maternity, as well as acute pain, and medical emergencies. In addition, the previously accumulated will be exhausted, old-age reserves.

Some time later, the man had to be hospitalized. The invoice in the amount of 1900 euros is not paid for private health insurance. Rather, they expected the existing contribution debts of the husband prior to placement in the Emergency plan.

emergency care, according to the BGH, by offset does not affect

now, As the Federal court of justice ruled that this is permissible. Generally speaking, a set-off of claims from an insurance contribution liabilities according to law. With the introduction of the emergency tariff, the legislator has limited this in any way. The set-off is also permissible if the money owed is not the policyholder but a third party, here the hospital.

The goal of the legislature to secure to all citizens, an emergency supply, not affected by the offset, in the Karlsruhe judgment. Because, in fact, help the needy, the Hartz IV social welfare services, would not be insured in the Emergency plan.