Subsequent premiums in private health insurance: ongoing payments, arrears, reminders

Legally, a subsequent premium differs clearly from the first premium. If the first premium is not paid, the insurer can still withdraw from the contract. For subsequent premiums, § 38 VVG sets out the procedure: a formal reminder with a payment deadline of at least two weeks. After that, you risk losing your claim to benefits for insured events during the period of arrears.

The full procedure of § 38 VVG, including the option to cancel under its paragraph 3, only applies to insurance that is not compulsory, for example supplementary insurance. For comprehensive health insurance, the special rules of § 193 VVG take priority. Contrary to a widespread error, § 39 VVG does not govern cancellation. It governs the premium settlement when a contract ends early.

A subsequent premium is due on the first working day of the payment period. Besides the standard monthly payment, you can pay quarterly, half-yearly or yearly. With direct debit, the insurer collects a few days in advance. What matters is that there is enough money in the account on the day of collection. If you switch to yearly payment, many insurers give you a discount on the annual premium.

Two practical points save trouble. After a change of bank account, the insurer should confirm the new mandate in writing before you close the old account. And after a premium adjustment, the existing mandate simply continues for the new amount. You do not need a new form.

If you pay your premium monthly and fall behind, you go through the stages of § 193 (6) VVG:

• from two monthly premiums in arrears, the insurer sends a reminder, and from this point the late payment surcharge of one percent per month applies
• if the arrears are not settled two months after the reminder, a second reminder follows
• if this also has no effect for one month, the contract is suspended and continues in the Notlagentarif

There the premium falls considerably, but cover shrinks to acute treatment, pain and benefits for pregnancy and maternity. For children, check-ups and vaccinations are added. The return to the old plan happens automatically once all arrears, including late payment surcharges and reminder costs, have been settled.

After a premium adjustment, the new amount is collected automatically, and the payment rhythm stays the same. During longer stays abroad, the contract generally continues and the subsequent premium stays due. During parental leave or a sabbatical, the full premium also stays due, while the employer contribution usually stops. Most unintended arrears arise in exactly these phases.

A change of employer does not change the duty to pay either. The contract is between you and the insurer. Only the contribution will come from the new employer in future.

From many years of looking after existing clients, we see reminders most often shortly after a change of bank account and during parental leave, almost never because of real inability to pay. We recommend that you deal with every reminder from the insurer within three working days at the latest. If the payment is then in the insurer's account within the reminder deadline, your claim to benefits remains.

If you can see a shortfall coming, contact the insurer before the first reminder. A deferral or a temporary change of payment interval is almost always cheaper than going through the stages of the process.

Much less than the regular plan, because the benefits are reduced to the bare minimum. The premium arrears do not disappear, however. They remain owed, including late payment surcharges, and must be settled in full for the return to the old plan.

No, the ageing reserves built up so far are not completely lost through the emergency plan. While the contract is suspended it continues to exist, but the benefits are much more limited. At the same time, part of the existing ageing reserves can be used to finance the premium in the emergency plan.

Contact the insurer at once and send proof of payment. Usually the payment and the reminder run simply crossed. What matters is that receipt of the payment is documented before further stages of the process are triggered.