Your private health insurer terminated without notice: causes, consequences, options

Private health insurers do not simply end contracts. When a letter arrives that ends the contract without notice, there is usually one of several triggers behind it:

• Pre-contractual duty of disclosure: if details of diagnoses, symptoms, treatments, medication or examinations were missing or wrong, the insurer checks very closely. Depending on the individual case, this can lead to a contract adjustment, rescission or, in case of fraudulent intent, avoidance. Disputes are especially common about pre-existing conditions and about treatments that were considered not relevant but are relevant to the risk from the insurer's point of view.
• Billing fraud or manipulated bills: false bills, services that were not provided or deliberately falsified documents count as a serious breach of trust and often lead to the immediate end of the contract.
• Other serious breaches of duty, for example repeated, serious breaches of contract. In practice, this point is much rarer than the other two.

The best solution depends on the reason for the termination. Several routes are possible:

• Objections to the termination: if you cannot follow the allegations, have the letter checked by an expert, react on time and in writing, and support your own view with documents.
• Contract adjustment instead of termination: sometimes the contract can be saved by an adjustment, for example with a risk surcharge or a benefit exclusion. This makes sense above all when there are no realistic alternatives.
• The Basistarif (i)BasistarifA statutory social plan that every private insurer must offer. Its benefits are comparable to statutory health insurance, and its premium is capped at the statutory maximum contribution.More about Basistarif → as a safety net: the Basistarif can stabilize your cover if a new contract becomes difficult. Its scope of benefits is roughly based on statutory care.
• A new contract with another insurer: possible, but often demanding with pre-existing conditions, which is why an anonymous enquiry is advisable before you apply.
• Check a return to statutory health insurance: only possible under certain conditions, depending on age, status, income and compulsory insurance.
• Ombudsman and arbitration: free of charge, and the decisions are binding on the insurer up to €10,000.
• Legal action: if the consequences threaten your livelihood, court proceedings may be necessary. Clarify their costs and chances in advance.

We have often heard the sentence “ARAG terminated my contract without notice” in requests for advice recently. ARAG Krankenversicherung is currently in particular focus when it comes to terminations because of breaches of the duty of disclosure. Since new plans were introduced at the end of 2020, there have been more and more cases in which ARAG ends existing contracts because of allegedly incorrect health details.

In our observation, there is a system behind the increased number of terminations. In recent years, ARAG invested heavily in sales and won many new customers through higher commissions. After the growth phase, a hard selection of the existing portfolio now seems to follow. Even the smallest bills for check-ups are examined.

ARAG does not offer terminated customers its own Basistarif (i). They therefore have to switch to another insurer. Regular insurance is possible even after such a termination. In a recent case, we were able to place a terminated customer with another insurer with a very small risk surcharge, much cheaper than the Basistarif.

In case of premium arrears, comprehensive private health insurance is as a rule not terminated without notice. Instead, the law provides for a dunning procedure. If the premium arrears remain despite reminders, the contract is suspended and the insured person is transferred to the Notlagentarif (i)NotlagentarifAn emergency plan for privately insured people who fall behind on their premiums. It covers only acute illness and pain, as well as pregnancy and childbirth, until the arrears are paid.More about Notlagentarif →.

The Notlagentarif (i) is not a regular comprehensive plan but a statutory safety net. It essentially reimburses benefits for acute illness, pain and pregnancy and maternity. The comprehensive benefits of the original plan are suspended during this time.

The premium in the Notlagentarif (i) is usually much lower than in the original plan. At the same time, the outstanding premium arrears, late payment surcharges and possible dunning costs remain. The way back into the original plan leads through paying off the arrears in full.

If you fall into premium arrears, you should contact the insurer in writing early on and seek a solution, for example an agreement to pay in installments. The earlier you react, the better the chance of avoiding the suspension of the contract.

A breach of the pre-contractual duty of disclosure is the cause that is more demanding in legal terms. When you apply, you must answer all health questions completely and truthfully. If you conceal a pre-existing condition, you risk the insurer rescinding the contract under § 19 VVG.

The right of rescission is limited in time. Under § 21 (3) VVG, it lapses five years after the contract was concluded, or after ten years for a deliberate or fraudulent breach. In case of rescission, the contract is dissolved retroactively, and benefits already paid can be reclaimed.

An important difference concerns causality. If the concealed circumstance had no influence on the insured event that occurred, the insurer must still pay for this event despite rescission (§ 21 (2) VVG). Only in case of fraud does this restriction not exist. If you are affected, you should have a lawyer check the original health questions.

The Notlagentarif (i) under § 193 VVG only applies in case of premium arrears. It is not a plan alternative you can choose freely but a statutory safety net for people who do not pay. The cover is much more limited and essentially includes acute illness, pain treatment and benefits for pregnancy and maternity.

The Basistarif (i) must be distinguished from it. It is regulated in § 152 VAG and can be a statutory safety net for people who are eligible. In 2026, the premium is capped at €1,017.18 per month, and the Pflegepflichtversicherung (i) is added on top. In case of need for assistance under social law, the premium can be reduced by half. The benefits of the Basistarif are comparable in type, scope and amount to the benefits of statutory health insurance.

Switching to a regular plan of another private health insurer is much more difficult, depending on your starting point. This usually requires new health questions. In addition, earlier problems with a contract, breaches of the duty of disclosure or premium arrears can play a role in the review.

From over 5,000 applications with health questions and advice cases that we have supported, a pattern emerges. Terminations without notice are rare, but quick action is decisive. We recommend that people affected check their follow-on options at the same time as objecting to the old insurer. The Basistarif (i) with its right to acceptance is the safest safety net.

If you are accused of breaching the duty of disclosure, it is worth inspecting the complete records at your family doctor and all specialists. It often turns out that the condition in question had not yet been diagnosed at the time of the application. In case of premium arrears, you can negotiate an installment plan or a premium break with the insurer.

The basis of every strategy is a careful review of the termination notice. Document deadlines and keep all correspondence in writing.

Events relevant to insurance are recorded in the HIS reference and information system of German insurers. An entry typically stays stored for up to five years and can make acceptance harder for new applications. Even without an entry, new applications involve a duty to provide information about earlier insurance contracts and the reason they ended.

In case of a fraudulent breach and rescission under § 19 VVG, yes. Otherwise, the right to reclaim is limited under § 21 (2) VVG. The insurer can only reclaim if the concealed circumstance caused the event that occurred. In a dispute, a lawyer needs to check the individual case.

In case of rescission under § 19 VVG because of a breach of the duty of disclosure, the right to take the ageing reserves with you usually ceases. In case of premium arrears, comprehensive health insurance is not terminated but continues in the Notlagentarif (i), so the ageing reserves are as a rule kept. After the contract has finally ended, a transfer is no longer possible.

Only under certain conditions. If you do not meet the requirements for compulsory insurance in statutory health insurance, for example as a self-employed person or civil servant, you have no right to be accepted. As an employee below the Jahresarbeitsentgeltgrenze (i)JAEG · JahresarbeitsentgeltgrenzeThe annual income threshold in Germany. Employees who earn more than this per year may leave statutory health insurance and switch to private health insurance.More about JAEG →, a return may be possible. In addition, the age limit under § 6 SGB V applies from age 55.

No. The transfer to the Notlagentarif (i) under § 193 (6) VVG requires a completed dunning procedure with several reminder letters and payment deadlines. A direct transfer without a prior dunning procedure is not lawful. If you doubt that it was lawful, the dunning procedure should be documented and checked by a lawyer.