Right to change plan in private health insurance: your claim and the duty to advise

§ 204 VVG gives policyholders the right at any time to switch to another plan with their own insurer. This means no new contract, no end of the contract and no loss of your ageing reserves.

With the same or a lower scope of benefits, the insurer has no right to new health questions. With a higher scope of benefits, case law of the Federal Court of Justice allows a review for the extra benefits. A complete rejection of the switch is never permitted.

§ 6 VVG obliges the insurer to advise you when there is an obvious reason, for example with premium adjustments, plan changes and specific requests from the policyholder. The duty covers information on switching options, available plan generations and financial effects.

If you can document incomplete advice, you may in individual cases have a claim to compensation for the extra costs incurred.

In practice, a clear process in four steps works well:

• Analyze your current plan and premium.
• Send a written request that names the scope of benefits precisely. Do not ask for cheaper plans in general, but list the benefit components you want one by one.
• If needed, ask about older plan generations.
• Submit the application and ask for the confirmation with the effective date.

From over 5,000 applications with health questions and advice sessions that we have supported, a pattern emerges. In practice, the right to change plan is rarely used to the full. Before you ask the insurer, we recommend doing market research. Then you know which plans exist on the market and can ask your own insurer more specifically.

If there is a documented breach of the duty to advise under § 6 VVG, legal representation by a lawyer can make sense. If the insurer faces insolvency, the right to change insurer should also be checked separately.

No, § 6 VVG obliges the insurer to advise you when there is an obvious reason. In practice, a request of your own still often makes sense, because the insurer interprets the obvious reason more narrowly than the law requires.

The law does not set a minimum period. Under § 208 VVG, the contract may not deviate from § 204 VVG to the disadvantage of the insured person.

That depends on the contract terms. If you switch during the insurance year, some plans cancel a claim that has not yet been paid out. If you switch at the end of the year, it usually remains. Ask the insurer about this before you switch.

No. The right to change plan under § 204 VVG only applies within your own insurer. A switch to another insurer is a change of insurer with different rules, that is full health questions and only a partial transfer of your ageing reserves.

As a rule, no. Whether you can use the right during a running waiting period depends on the specific insurance terms. Usually it applies without restriction once the waiting period has ended.