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No shared register in private health insurance
Private health insurers store rejections in their own systems, not in a shared database. A rejection by one insurer is not a rejection by the next.
Application for private health insurance rejected: what you can do now
If you learn that your application for private health insurance has been rejected, you may fear that the way into private health insurance is closed for good. As a rule, that is not the case. A rejection at first only means that this one insurer does not want to accept the application on the stated terms. Another insurer can decide differently. Which route makes sense depends on the reason for the rejection, on your health details and on your personal starting situation.
Guide
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The key points for dealing with a rejection by a private health insurer at a glance.
Contents
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How does the consultation work? →Which condition leads to which outcome in the health questions?
Choose a condition Usually accepted Usually accepted Usually accepted Usually accepted Usually accepted Risk surcharge likely Benefit exclusion likely Benefit exclusion likely Risk surcharge likely Risk surcharge likely Rejection likely Rejection likely Risk surcharge likely Risk surcharge likely Risk surcharge likely Risk surcharge likely Risk surcharge likely Risk surcharge likely Risk surcharge likely Rejection likely Rejection likely Rejection likely Rejection likely Rejection likely Rejection likely
Usually acceptance on standard terms, because the injury has healed and no follow-up risk remains.
- What it depends on
- Complete healing without lasting complaints.
- How long
- An exclusion is generally not to be expected here.
- How it can be resolved
- Not necessary.
Usually standard terms, because healed and without follow-up risk.
- What it depends on
- A completed operation without complications.
- How long
- Generally no exclusion.
- How it can be resolved
- Not necessary.
Usually standard terms. If complaints remain, a risk surcharge is possible.
- What it depends on
- Time since the operation and whether you are currently free of complaints.
- How long
- If an exclusion is agreed, it applies without a time limit.
- How it can be resolved
- After a lasting period without complaints, you can request a review.
Usually standard terms. With repeated episodes, a risk surcharge is possible.
- What it depends on
- A single event or recurring complaints.
- How long
- Rarely an exclusion.
- How it can be resolved
- Not critical if you are free of complaints.
Mild, well controlled allergies usually count as non-critical and are often accepted without conditions.
- What it depends on
- Severity of the allergy and need for treatment.
- How long
- Rarely an exclusion.
- How it can be resolved
- Usually not required.
If healed without after-effects, a risk surcharge is more likely.
- What it depends on
- Treatment status, how long you have been free of complaints and the individual insurer.
- How long
- A risk surcharge remains in place. A review makes sense after several years without complaints.
- How it can be resolved
- A medical certificate confirming that it has healed, then a new assessment by the insurer.
Teeth that have not been replaced often lead to a surcharge or a benefit exclusion in the dental area. Replaced teeth are usually unproblematic.
- What it depends on
- Number of gaps and the planned dental restoration.
- How long
- The exclusion applies specifically to the dental area.
- How it can be resolved
- After the restoration, the exclusion can be reassessed.
During ongoing treatment, an exclusion usually applies. Afterwards, regular acceptance is possible.
- What it depends on
- Completion of the treatment.
- How long
- Limited until the treatment ends.
- How it can be resolved
- Open to reassessment as soon as the treatment is finished.
A risk surcharge is more likely than standard terms.
- What it depends on
- Course of treatment and insurer.
- How long
- A risk surcharge remains in place. A later review is possible.
- How it can be resolved
- A new assessment after a stable course without complaints.
Manifest chronic diagnoses tend to lead to a risk surcharge rather than acceptance on standard terms. Severe cases can lead to rejection.
- What it depends on
- Severity and stability of the course.
- How long
- A surcharge remains in place permanently.
- How it can be resolved
- If your condition has demonstrably improved, you can request a review.
Ongoing or recently completed psychological treatment usually leads to rejection or to the application being deferred. A benefit exclusion is rarely an option in that case.
- What it depends on
- Time since the last treatment and type of diagnosis.
- How long
- After a sufficient period without complaints, a reassessment is possible.
- How it can be resolved
- Reassessment after a period without complaints, ideally through an anonymous enquiry.
Regular acceptance is usually not possible. A benefit exclusion is then not an option, because the contract is not concluded at all.
- What it depends on
- Course and accompanying conditions.
- How long
- Acceptance generally fails.
- How it can be resolved
- Options are the Basistarif as the fallback plan and an anonymous enquiry to several insurers.
Many insurers accept asthma with a risk surcharge. Some providers do not insure asthma and exclude it. A rejection is rather rare.
- What it depends on
- Severity and frequency of complaints and the individual insurer.
- How long
- A surcharge remains in place. An exclusion applies without a time limit. With a stable course, a review is possible.
- How it can be resolved
- An anonymous enquiry to several providers. There you will often find insurers with a moderate surcharge.
Well controlled high blood pressure is usually accepted with a risk surcharge. High readings, several medications or damage to the cardiovascular system make the assessment clearly worse.
- What it depends on
- Level of the readings, number of medications, accompanying diagnoses and the individual insurer.
- How long
- A surcharge remains in place permanently. An exclusion applies without a time limit.
- How it can be resolved
- Prove stable readings over a longer period, then request a review from the insurer.
An underactive thyroid that is well controlled with medication is often accepted with a moderate risk surcharge. Some insurers assess it more mildly than others.
- What it depends on
- Stable blood values under treatment, the cause of the underactive thyroid and accompanying findings.
- How long
- A surcharge remains in place until it is reduced on request.
- How it can be resolved
- An anonymous enquiry to several providers. The differences are often large here.
Endometriosis usually leads to a risk surcharge. With active treatment, the assessment is stricter.
- What it depends on
- Stage, need for treatment, past operations and the individual insurer.
- How long
- A risk surcharge remains in place permanently.
- How it can be resolved
- After a longer period without complaints and without treatment, you can request a review.
Mild cases are often accepted with a surcharge. With regular treatment with cortisone or modern active substances, a higher risk surcharge for skin conditions is likely.
- What it depends on
- Severity of flare-ups, treatment interval and the medications used.
- How long
- A risk surcharge remains in place permanently.
- How it can be resolved
- Have several years without treatment confirmed by a doctor, then a new assessment.
Mild acne usually has no consequences. Cases that need treatment, especially with prescription medication, often lead to a surcharge for the skin area.
- What it depends on
- Severity, current treatment and type of medication.
- How long
- A risk surcharge remains in place permanently and applies specifically to skin conditions.
- How it can be resolved
- Have it reassessed once the treatment is finished and the skin has healed.
A single event that healed without after-effects often leads only to a small surcharge, sometimes also to standard terms.
- What it depends on
- Number of episodes, time since the last event and current findings.
- How long
- A risk surcharge remains in place permanently.
- How it can be resolved
- After several years without a new event, request a review from the insurer.
Regular acceptance is usually not possible. The course and the time since treatment are decisive.
- What it depends on
- Type of disease, course and time since therapy.
- How long
- Acceptance generally fails.
- How it can be resolved
- After a long period without complaints, a reassessment can make sense.
These diagnoses are among the common reasons for rejection. Excluding individual benefits does not replace regular acceptance in that case.
- What it depends on
- Diagnosis and course.
- How long
- Acceptance generally fails.
- How it can be resolved
- The Basistarif as the fallback plan, plus an anonymous enquiry.
Chronic bowel diseases are among the common reasons for rejection, but the assessment varies from insurer to insurer.
- What it depends on
- Course, need for treatment and provider.
- How long
- Acceptance often fails.
- How it can be resolved
- An anonymous enquiry to several insurers.
A documented ADHD diagnosis often leads to rejection, especially with ongoing medication.
- What it depends on
- Time since the last treatment, medication and the individual insurer.
- How long
- Acceptance generally fails.
- How it can be resolved
- An anonymous enquiry to several providers, plus the Basistarif as the fallback plan.
Treated sleep apnea often leads to rejection, especially with ventilation at night.
- What it depends on
- Severity, type of therapy and accompanying diagnoses.
- How long
- Acceptance generally fails.
- How it can be resolved
- An anonymous enquiry to several insurers. The assessment differs from insurer to insurer here.
Information about drug use generally leads to rejection. The time since the last use is decisive.
- What it depends on
- Type and frequency of use and the time since the last use.
- How long
- Acceptance generally fails.
- How it can be resolved
- After a longer documented period without use, a reassessment is possible, ideally through an anonymous enquiry.
Typical outcome based on more than 5,000 applications with health questions that we have supported. This is not a promise. Only an anonymous enquiry to several insurers gives you a binding answer for your case.
After the rejection: options and background
Which routes are open after a rejection?
After a rejection, several routes are open. Which one fits depends on the reason for the rejection, your state of health and your personal situation:
- Another insurer: Because there is no shared register, another insurer can accept the same person on different terms. Risk assessment and acceptance criteria differ considerably, and some insurers assess certain pre-existing conditions less strictly.
- Anonymous risk enquiry: Through an independent broker, you can check whether you can be insured with several insurers at the same time, without application data being sent. No formal entries arise in the insurers' systems.
- Accept a risk surcharge: Some insurers do not reject completely, but offer a plan with a risk surcharge. A surcharge of 15 to 30 percent is typical, more with serious conditions. If you accept the surcharge, you get full cover at a higher premium.
- Basistarif: Under § 152 VAG, every eligible person has a right to be accepted into the Basistarif by every licensed insurer. This is the fallback option if the other routes fail.
All these routes require that the pre-existing conditions were stated completely and correctly under § 19 VVG. If incorrect details played a role in the rejection, legal clarification makes sense.
What is the industry register (HIS) in private health insurance?
In motor and household contents insurance, insurers use the HIS information system of the German Insurance Association (GDV) to prevent fraud. If you are flagged there, this is noted across the industry. Private health insurers are not connected to this system. Health data is stored internally by the respective insurer and is subject to data protection.
Some insurers work with specialized service providers such as MEDICPROOF, which carry out medical risk assessments. The result stays with the insurer that commissioned it and cannot be seen by other insurers.
The practical consequence: a rejection by one insurer does not mean that the next one will make the same decision. Risk assessment is not harmonized, and some insurers have much narrower underwriting guidelines than others. That is why the anonymous enquiry through a broker who checks several insurers at the same time is the direct route to an overview.
Which pre-existing conditions almost always lead to a rejection?
Some pre-existing conditions lead directly to a rejection in the vast majority of cases. For many of them, good documents can still keep a chance alive:
- Mental illness: The application should always include a detailed report from the therapist with an exact description of the symptoms, as well as a medical finding and a description of the course and the prescribed medicines. After at least five years without treatment and symptoms, acceptance without surcharges is possible, but some companies ask about ten years.
- ADD and ADHD: It is hard for those affected, but depending on the course of the condition, joining with a risk surcharge is possible. If you become a civil servant for the first time, you can enter private health insurance through the Öffnungsaktion ÖffnungsaktionA one-off entry offer of private insurers for new civil servants. Applicants are accepted despite pre-existing conditions, with a capped risk surcharge..
- Stroke: Reputable insurers rule out accepting an application after a stroke. Then only joining through the Basistarif is possible, for which there is an obligation to contract.
- Cancer: Cancer is one of the serious conditions and is viewed particularly critically in the health questions. A known cancer must be stated in the application and as a rule leads to rejection.
- Insulin-dependent type 1 diabetes: Unlike type 2 diabetes, you should expect a rejection or at least a benefit exclusion. Details that are as complete as possible are important.
- Ongoing dental treatment: Usually the ongoing dental treatment is excluded from benefits, and the rest of the cover applies. With ongoing orthopedic treatment, most insurers refuse acceptance.
The following, among others, are also considered practically uninsurable:
- AIDS
- Alzheimer's disease
- Crohn's disease
- ulcerative colitis
- anorexia
- hemophilia
- bulimia
- drug addiction
- heart attack and heart valve defects
- leukemia
- pulmonary fibrosis
- multiple sclerosis
- kidney failure
- Parkinson's disease
- contracted kidney
- pneumoconiosis
- hydrocephalus
How does the Basistarif work as a fallback option?
The Basistarif under § 152 VAG is a statutory safeguard for people who drop out of other plans or are not accepted. Every licensed private health insurer is obliged to accept you, and the right exists regardless of your state of health.
The premium is at most the maximum contribution of statutory health insurance, in 2026 around €1,017.18 per month. If you are in need of assistance, it can fall further. The benefits are set by law and roughly correspond to the cover of statutory health insurance, without the optional services of regular plans.
The Basistarif has one clear advantage: guaranteed insurability. If you cannot get a regular plan for health reasons, you should know it as an option.
What do we advise after a rejection?
From more than 5,000 applications with health questions, we see that a considerable share of rejections goes back to imprecise wording in the health details, not to actual uninsurability. Many applicants describe pre-existing conditions imprecisely or name diagnoses that the treating doctor never made in that form.
Before any further attempt, we recommend requesting the original reason for the rejection in writing and looking at your own medical records at your family doctor. This clarifies whether the rejection has a clear medical basis or rests on a formal inaccuracy.
If the insurer raises an allegation under § 19 VVG, that is, claims that relevant pre-existing conditions were concealed or stated incorrectly, legal advice makes sense. The consequences of such a finding can be considerable.
After several rejections by different insurers, a complete risk clarification before the next application is advisable. The Basistarif should then also be included as a safe option, even if its benefits fall short of regular plans.
Do I have to state an earlier rejection in a new application?
Yes. The duty of disclosure under § 19 VVG also applies to earlier rejections. If you conceal a rejection, you later risk avoidance of the contract for fraudulent misrepresentation. Correct details also apply to the anonymous risk enquiry through a broker.
How long does an insurer store a rejection?
There is no period set by law. Most insurers store internal rejection data for several years. Because there is no shared register, the storage only concerns the insurer that rejected you, not the industry.
Can I ask the same insurer again after a rejection?
In principle yes, but after one year at the earliest and only if your health situation has demonstrably changed. Some insurers have internal blocking periods. It makes more sense to check other insurers first through the anonymous risk enquiry.
What does the Basistarif cost for people entitled to Beihilfe?
Civil servants entitled to Beihilfe take out a supplementary plan that tops up the Beihilfe BeihilfeThe state healthcare allowance for civil servants. The Beihilfestelle pays a fixed share of medical costs, the Beihilfesatz, and private insurance covers the rest.More about Beihilfe →. In the Basistarif , the premium falls in line with the Beihilfesatz. Your own share is well below the full premium of around €1,017.18 per month.
When does legal advice make sense after a rejection?
If the insurer raises an allegation under § 19 VVG, legal advice makes sense, because the consequences can be considerable. With a regular rejection without an allegation, advice from a broker is the first step.
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Switching to private health insurance is probably not advisable for you.
From the age of 55, admission to private health insurance is often possible only with restrictions. A late switch can also mean higher premiums.
It matters to us that a switch pays off for you in the long run. That is why we do not recommend a consultation when your answers already show that the conditions are rather unfavorable.
Not sure, or want to correct your answers? Feel free to contact us. We will help you assess your situation.
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