Kindernachversicherung in private health insurance: deadline, application and special cases

§ 198 VVG obliges private health insurers to accept newborns and adopted children within the deadline without health questions. The law creates a special right of admission that the parties cannot negotiate away. Insurers can be more generous than the law, not more restrictive.

The deadline is 2 months from birth. What counts is the date on which the insurer receives the application. The previous insurance period of 3 months must have passed at the time of birth, not only at the time of the application. A parent who joined private health insurance 2 months before the birth does not meet the requirement.

Which parent meets the previous insurance period is a free choice. If both parents have private health insurance, they can decide through which parent and which insurer the child is accepted. This affects the child's plan, because in practice the child takes on the plan level of that parent.

Registering in time protects you fully, meaning without health questions, without waiting periods and without a risk surcharge. This also applies to premature babies, children with documented findings from the pregnancy and chronically ill children. The statutory protection applies without conditions, as long as the deadline and the requirement for the parents are met.

The application process is straightforward if the documents are prepared.

• Step 1: Get the birth confirmation. Right after the birth, the hospital issues a birth confirmation. This document is enough to start the application immediately. The birth certificate from the registry office usually follows 3 to 4 weeks later.
• Step 2: Submit the application. An informal letter to the insurer with a note on the choice of plan and the birth confirmation is enough to start the application. Some insurers require their own application form, which you should request in advance if in doubt.
• Step 3: Make sure the sending can be proven. Send it by registered mail or by email with a read receipt. Keep the receipt. What counts is the date on which the insurer receives it.
• Step 4: Check the confirmation of the contract. The insurer sends a confirmation with the premium, plan and start date. The start date must be the date of birth. Clarify any differences with the insurer immediately.

A tip on the employer contribution: if a parent has private health insurance and the maximum employer contribution has not yet been fully used, the employer can, under certain conditions, also pay towards the child's private premium. In practice, the employer then generally pays up to 50 percent of the child's premium, but only within the statutory maximum employer contribution and provided the child would in principle qualify for family insurance in statutory health insurance. That is why it is worth looking closely, before registering, at which parent still has room in the employer contribution.

From over 5,000 applications with health questions, we know the most common mistake. The application slips into week 3 or 4, because the parents wait for the birth certificate or because complications after the birth delay everything. By then, half of the deadline is used up.

We recommend requesting the application documents from the insurer in the last weeks of the pregnancy. The application then starts in week 1, even if the birth is more complicated than planned.

Special case adoption: § 198 (2) VVG treats the adoption of a minor child in the same way as a birth. The deadline starts with the adoption, not on the child's date of birth. The same applies to international adoption, provided the adoption is legally effective.

Special case birth abroad: The application is made with a certified translation of the birth confirmation. The time needed for the translation is deducted from the deadline. If you give birth abroad, you should inform the insurer in advance.

Special case parent with an Anwartschaft (i): A parent who has an Anwartschaftsversicherung does not have comprehensive cover. The previous insurance period for the parent is therefore not met. Only after the move to comprehensive health insurance and the end of the three-month period does the right to the Kindernachversicherung (i) apply for future children.

No. If you register in time, § 198 VVG rules out a rejection or a risk surcharge, regardless of the child's state of health. This is the core of the statutory protection. If you apply within 2 months and the parent meets the previous insurance requirement, you have an enforceable claim.

§ 198 VVG expressly names newborns and adopted children. Foster children are usually not included, unless the insurer offers this voluntarily in its insurance terms. If you take in a foster child, you should ask the insurer directly in advance.

A separate application is needed for each child, and each child gets a contract of its own. The two-month deadline applies to each child from the same date of birth. In practice, both applications are submitted at the same time.

Yes. The Kindernachversicherung (i) under § 198 VVG applies to the same insurer with which the parent has comprehensive cover. Acceptance by another insurer on the basis of § 198 VVG is not possible. The other insurer can accept the child, but under its regular acceptance terms with health questions.

If you register in time within the deadline, neither a risk surcharge nor a rejection applies, even for findings known before birth. The statutory protection under § 198 VVG does not allow these restrictions during the special admission phase.